Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patients
Background: 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 facto...
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Elsevier
2024-12-01
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| Series: | Oral Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772906024005326 |
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| author | P.J. Nagarathna Santosh R. Patil |
| author_facet | P.J. Nagarathna Santosh R. Patil |
| author_sort | P.J. Nagarathna |
| collection | DOAJ |
| description | Background: 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. Methods: 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. Results: 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. Conclusion: 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. |
| format | Article |
| id | doaj-art-284e8f5276c54c0898a74c47c9e3e11e |
| institution | Kabale University |
| issn | 2772-9060 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Oral Oncology Reports |
| spelling | doaj-art-284e8f5276c54c0898a74c47c9e3e11e2024-12-06T05:15:26ZengElsevierOral Oncology Reports2772-90602024-12-0112100686Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patientsP.J. Nagarathna0Santosh R. Patil1Department of Pediatric Dentistry, Chhattisgarh Dental College and Research Institute, IndiaDepartment of Oral Medicine and Radiology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, C.G, India; Corresponding author.Background: 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. Methods: 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. Results: 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. Conclusion: 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.http://www.sciencedirect.com/science/article/pii/S2772906024005326Medication-related osteonecrosis of the jaw (MRONJ)Antiresorptive agentsAntiangiogenic therapyRisk factorsSurgical intervention |
| spellingShingle | P.J. Nagarathna Santosh R. Patil Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patients Oral Oncology Reports Medication-related osteonecrosis of the jaw (MRONJ) Antiresorptive agents Antiangiogenic therapy Risk factors Surgical intervention |
| title | Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patients |
| title_full | Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patients |
| title_fullStr | Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patients |
| title_full_unstemmed | Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patients |
| title_short | Preliminary analysis of incidence, risk factors, and management of medication-related osteonecrosis of the jaw in cancer patients |
| title_sort | preliminary analysis of incidence risk factors and management of medication related osteonecrosis of the jaw in cancer patients |
| topic | Medication-related osteonecrosis of the jaw (MRONJ) Antiresorptive agents Antiangiogenic therapy Risk factors Surgical intervention |
| url | http://www.sciencedirect.com/science/article/pii/S2772906024005326 |
| work_keys_str_mv | AT pjnagarathna preliminaryanalysisofincidenceriskfactorsandmanagementofmedicationrelatedosteonecrosisofthejawincancerpatients AT santoshrpatil preliminaryanalysisofincidenceriskfactorsandmanagementofmedicationrelatedosteonecrosisofthejawincancerpatients |