Authors: Van den Wyngaert, T.; Claeys, T.; Huizing, M. T.; Vermorken, J. B.; Fossion, E.

Source: Annals of Oncology, Volume 20, Number 2, 14 February 2009 , pp. 331-336(6)

Publisher: Oxford University Press

Abstract:

Background: Overall survival (OS) and outcome of cancer patients with bisphosphonate-associated osteonecrosis of the jaw (ONJ) using conservative treatment (chlorhexidine 0.12% rinse, intermittent antibiotics, and careful sequestrectomy) are unknown.

Design: In all, 33 ONJ patients were studied for OS and ONJ outcome.

Results: Median duration of bisphosphonate treatment was 27 months (range 4115) and was stopped in 25 (76%) patients. Nine (27%) cases presented with stage 1, 21 (64%) with stage 2, and 3 (9%) with stage 3 disease. During median follow-up of 23 months, 11 patients (33%) died (median survival 39 months), with no ONJ-related fatalities. Out of 30 assessable patients, 53% no longer had exposed bone, 37% had stable lesions, and 10% showed progressive necrosis. The hazard ratio for healing with doubling of bisphosphonate exposure was 0.419 [95% confidence interval (CI) 0.1780.982; P 0.045], stage 2 versus stage 1 disease 0.216 (95% CI 0.0630.738; P 0.015), and stage 3 versus stage 1 disease 0.084 (95% CI 0.0080.913; P 0.042). Cessation of bisphosphonate treatment did not influence outcome.

Conclusions: Conservative treatment of ONJ leads to mucosal closure in 53% of patients. Doubling the exposure time to bisphosphonates and higher stages of ONJ significantly reduce ONJ healing rates.

Keywords: bisphosphonates; jaw; ONJ; osteonecrosis; outcome study

Document Type: Research article

DOI: http://dx.doi.org/10.1093/annonc/mdn630

Publication date: 2009-02-14

More about this publication?

• Annals of Oncology is a multidisciplinary journal that publishes articles addressing medical oncology, surgery, radiotherapy, paediatric oncology, basic research and the comprehensive management of patients with malignant diseases.

Related content

• In this: publication
• By this: publisher
• In this Subject: Oncology
• By this author: Van den Wyngaert, T. ;  Claeys, T. ;  Huizing, M. T. ;  Vermorken, J. B. ;  Fossion, E.

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers