Document Detail

Bisphosphonate-induced osteonecrosis of the jaw (ONJ): Incidence and risk factors in patients with breast cancer and gynecological malignancies.
MedLine Citation:
PMID:  19136147     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Since 2003, multiple cases of bisphosphonate-induced osteonecrosis of the jaw (ONJ) were reported. The aim of this study was to describe the incidence and risk factors of ONJ in patients with breast cancer or gynecological malignancies receiving bisphosphonates (BP). METHODS: ONJ was recorded for all patients with breast cancer or gynecological malignancies treated with intravenous bisphosphonates at the Department of Gynecology and Obstetrics, University Hospital Tuebingen during April, 1999 and May, 2006. RESULTS: 10 of 345 (2.9%) patients with breast cancer or gynecological malignancies developed ONJ while receiving bisphosphonate therapy. Six patients with ONJ had a history of recent dental procedures. All patients had received zoledronic acid as part of their bisphosphonate regimen. Time of exposure to bisphosphonates and the number of treatment cycles were significant risk factors for the development of ONJ (p<0.001). In patients diagnosed with ONJ the mean number of treatment cycles was 27+/-18 cycles. However, the mean number of treatment cycles in patients without manifestation of ONJ was 12+/-12 cycles. CONCLUSION: Length of exposure to BPs and the cumulative dose of given BPs seem to be the most important risk factors for the development of ONJ followed by dental procedures.
T Fehm; V Beck; M Banys; H P Lipp; M Hairass; S Reinert; E F Solomayer; D Wallwiener; M Krimmel
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Publication Detail:
Type:  Journal Article     Date:  2009-01-12
Journal Detail:
Title:  Gynecologic oncology     Volume:  112     ISSN:  1095-6859     ISO Abbreviation:  Gynecol. Oncol.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-02-27     Completed Date:  2009-03-16     Revised Date:  2010-10-04    
Medline Journal Info:
Nlm Unique ID:  0365304     Medline TA:  Gynecol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  605-9     Citation Subset:  IM    
Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, 72076 Tuebingen, Germany.
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MeSH Terms
Bone Neoplasms / drug therapy,  secondary
Breast Neoplasms / drug therapy*,  pathology
Diphosphonates / administration & dosage,  adverse effects*
Drug Administration Schedule
Genital Neoplasms, Female / drug therapy*,  pathology
Imidazoles / administration & dosage,  adverse effects
Jaw / pathology*
Middle Aged
Osteonecrosis / chemically induced*
Risk Factors
Reg. No./Substance:
0/Diphosphonates; 0/Imidazoles; 118072-93-8/zoledronic acid
Comment In:
Breast. 2010 Oct;19(5):432-3; author reply 433-4   [PMID:  20363135 ]

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