Osteonecrosis of the maxilla and mandible in patients with advanced cancer treated with bisphosphonate therapy Journal Article


Authors: Estilo, C. L.; Van Poznak, C. H.; Williams, T.; Bohle, G. C.; Lwin, P. T.; Zhou, Q.; Riedel, E. R.; Carlson, D. L.; Schoder, H.; Farooki, A.; Fornier, M.; Halpern, J. L.; Tunick, S. J.; Huryn, J. M.
Article Title: Osteonecrosis of the maxilla and mandible in patients with advanced cancer treated with bisphosphonate therapy
Abstract: Cases of osteonecrosis of the jaw (ONJ) have been reported with an increasing frequency over the past 5 years. ONJ is most often identified in patients with cancer who are receiving intravenous bisphosphonate (IVBP) therapy, but it has also been diagnosed in patients receiving oral bisphosphonates for nonmalignant conditions. To further categorize risk factors associated with ONJ and potential clinical outcomes of this condition, we performed a retrospective study of patients with metastatic bone disease treated with intravenous bisphosphonates who have been evaluated by the Memorial Sloan-Kettering Cancer Center Dental Service between January 1, 1996 and January 31, 2006. We identified 310 patients who met these criteria. Twenty-eight patients were identified as having ONJ at presentation to the Dental Service and an additional 7 patients were subsequently diagnosed with ONJ. Statistically significant factors associated with increased likelihood of ONJ included type of cancer, duration of bisphosphonate therapy, sequential IVBP treatment with pamidronate followed by zoledronic acid, comorbid osteoarthritis or rheumatoid arthritis, and benign hematologic conditions. Our data do not support corticosteroid use or oral health as a predictor of risk for ONJ. Clinical outcomes of patients with ONJ were variable with 11 patients demonstrating improvement or healing with conservative management. Our ONJ experience is presented here. ©AlphaMed Press.
Keywords: treatment outcome; retrospective studies; major clinical study; thalidomide; bevacizumab; doxorubicin; advanced cancer; drug safety; monotherapy; treatment duration; bone metastasis; methotrexate; bortezomib; multiple myeloma; breast cancer; anemia; risk factors; bisphosphonic acid derivative; cyclophosphamide; retrospective study; risk factor; risk assessment; prostate cancer; statistical significance; thalassemia; rheumatoid arthritis; osteoarthritis; corticosteroid; blood clotting disorder; infusions, intravenous; diphosphonates; maxilla; bone necrosis; jaw disease; bone density conservation agents; osteonecrosis; zoledronic acid; imidazoles; mandible; mouth hygiene; osteonecrosis of the jaw; pamidronic acid; sickle cell anemia; jaw; pamidronate; bisphosphonate therapy; madible osteonecrosis; mandible osteonecrosis; maxilla osteonecrosis; jaw neoplasms
Journal Title: The Oncologist
Volume: 13
Issue: 8
ISSN: 1083-7159
Publisher: AlphaMed Press  
Date Published: 2008-08-01
Start Page: 911
End Page: 920
Language: English
DOI: 10.1634/theoncologist.2008-0091
PUBMED: 18695259
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 36" - "Export Date: 17 November 2011" - "CODEN: OCOLF" - "Source: Scopus"
Altmetric
Citation Impact
MSK Authors
  1. Azeez Farooki
    46 Farooki
  2. Joseph M Huryn
    80 Huryn
  3. Jerry L Halpern
    11 Halpern
  4. Steven J Tunick
    8 Tunick
  5. George C Bohle
    17 Bohle
  6. Cherry Estilo
    68 Estilo
  7. Diane Carlson
    52 Carlson
  8. Heiko Schoder
    317 Schoder
  9. Qin Zhou
    137 Zhou
  10. Monica Nancy Fornier
    143 Fornier