BISPHOSPHONATES RELATED OSTEONECROSIS OF THE JAW IN CANCER PATIENTS – EPIDEMIOLOGICAL STUDY

Abstract

Aim of the study Medication related osteonecrosis of the jaw (MRONJ) is a severe drug adverse effect, often being diagnosed in an advanced stage. The aim of this epidemiological study was to determine the frequency of MRONJ in cancer patients from Oltenia region, during 2012-2017. Material and methods Data retrieved from the clinical charts and used in this study were age, gender, residency, neoplasm type, location, and stage of MRONJ. Microsoft Excel and SPSS for Windows were used for analysis. Results The study included 57 patients, 31 females and 26 males, mean age 63.8±9.8. MRONJ was found in older patients, females mostly under 65 years old, males mostly over 65 years old (p = 0.023). Age distribution was correlated with the neoplasm type, while median ages between the breast neoplasm (58.5 years old) and prostate neoplasm (70 years old) groups were significantly different (p = 0.002). All patients with MRONJ have been previously treated with intravenous zoledronic acid for bone metastasis. Mandibular MRONJ was 2.35 times more frequent than maxillary MRONJ (p = 0.002) and stage II of MRONJ was commonly encountered. Conclusions MRONJ has been found mostly in patients with breast or prostate adenoma cancers with bone metastases who have been treated with intravenous. zoledronic acid and was present especially in the lower jaw, in advanced stages.

Keywords

• bisphosphonate-associated osteonecrosis of the jaw
• diphosphonates
• mandible
• osteonecrosis
• neoplasms