Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patients
Year: 2024
Type: article
Study design: Observational Study
Abstract: Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with antiresorptive and antiangiogenic therapies commonly used to manage bone metastasis and improve bone density in cancer patients. This study aimed to investigate MRONJ's incidence, risk factors, and outcomes of MRONJ in patients receiving these therapies. A retrospective cohort study was conducted involving 98 patients who had received antiresorptive or antiangiogenic medications for at least one year. Data were collected from the electronic health records, focusing on demographics, medication details, comorbidities, dental history, and MRONJ status. Logistic regression analysis was used to identify predictors of MRONJ, and Kaplan-Meier survival analysis was used to assess treatment outcomes, comparing surgical and conservative management approaches. The incidence of MRONJ was 21.4 % among the study cohort. Logistic regression identified prolonged medication duration (odds ratio [OR] = 2.5; p = 0.01), comorbidities (OR = 3.2; p = 0.003), and prior dental procedures (OR = 2.1; p = 0.02) as significant predictors of MRONJ. Kaplan-Meier analysis showed that surgical intervention resulted in longer survival (median 24.5 Â months) than conservative management (median 12.8 months; p < 0.01). Despite the high rates of healing (71.4 %) and pain management success (85.7 %), a recurrence rate of 23.8 % indicated MRONJ's chronic nature of MRONJ. This study underscores the importance of early identification and interdisciplinary management of MRONJ risk factors, particularly in patients with prolonged antiresorptive or antiangiogenic therapy. Surgical intervention appears beneficial; however, high recurrence rates emphasize the need for vigilant monitoring and patient-specific treatment strategies. • 21.4 % incidence of MRONJ in cancer patients on antiresorptive/antiangiogenic therapies. • Key MRONJ predictors include prolonged therapy, comorbidities, and prior dental procedures. • Surgical intervention shows extended survival benefits over conservative management in MRONJ cases. • High healing and pain management success rates, yet 23.8 % recurrence emphasizes chronic MRONJ nature. • Early identification and interdisciplinary management improve MRONJ outcomes in high-risk patients.
Source: Oral Oncology Reports
Authors: P.J. Nagarathna, Santosh R. Patil
Institution: Chhattisgarh Dental College & Research Institute
Language: English
Topic: Bone health and treatments
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,100
OpenAlex ID: W4404514912