Prognosis by cancer type and incidence of zoledronic acid-related osteonecrosis of the jaw: a single-center retrospective study.

Abstract

PURPOSE:

Survival time after bisphosphonate use has been increasingly recognized to be associated with the incidence of medication-related osteonecrosis of the jaw (MRONJ); however, this has not been elucidated sufficiently in the literature. This study aimed to clarify the incidence of MRONJ and the corresponding survival rate of patients treated with zoledronic acid (ZA) for each type of cancer and obtain useful information for the oral/dental supportive care of cancer patients.

METHODS:

We evaluated 988 patients who were administered ZA at our hospital; among them, 862 patients with metastatic bone tumors or myeloma were included.

RESULTS:

The median survival time (MST) after ZA initiation was 35, 34, 8, 41, 12, and 6 months for patients with breast, prostrate, lung, myeloma, renal, and other cancers, respectively. Patients with cancers that had a short survival time (lung and other cancers [MST = 8 and 6 months, respectively] and cancers with MST < 10 months) did not develop MRONJ; this could be attributed to the shorter duration of ZA administration. The cumulative incidence of MRONJ in breast cancer, prostate cancer, and multiple myeloma was related to the frequency of anti-resorptive drug use and the increased risk over time. In renal cancer, the cumulative incidence of MRONJ increased early, although the MST was 12 months.

CONCLUSION:

For the dentists in charge of dental management, it is essential to be aware of prognosis-related factors, predict MRONJ risk for each cancer treatment, and use risk prediction in dental management planning, particularly for cancers with non-poor prognosis.

• Authors: Hironobu Hata, Kenji Imamachi, Michihiro Ueda, Masashi Matsuzaka, Hiroaki Hiraga, Toshihisa Osanai, Toru Harabayashi, Katsuya Fujimoto, Satoshi Oizumi, Masato Takahashi, Kazuhito Yoshikawa, Jun Sato, Yutaka Yamazaki, Yoshimasa Kitagawa
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 30 Issue 5 Pg. 4505-4514 (May 2022) ISSN: 1433-7339 [Electronic] Germany
• PMID: 35113225 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Bone Density Conservation Agents
• Diphosphonates
• Denosumab
• Zoledronic Acid

Topics

• Bisphosphonate-Associated Osteonecrosis of the Jaw (drug therapy, epidemiology, etiology)
• Bone Density Conservation Agents (adverse effects)
• Bone Neoplasms (drug therapy)
• Denosumab (therapeutic use)
• Diphosphonates (adverse effects)
• Humans
• Incidence
• Male
• Prognosis
• Retrospective Studies
• Zoledronic Acid (adverse effects)