Fehm T, Beck V, Banys M, Lipp H P, Hairass M, Reinert S, Solomayer E F, Wallwiener D, Krimmel M
Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, 72076 Tuebingen, Germany.
Gynecol Oncol. 2009 Mar;112(3):605-9. doi: 10.1016/j.ygyno.2008.11.029. Epub 2009 Jan 12.
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).
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.
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.
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.
自2003年以来，有多项关于双膦酸盐类药物引起颌骨坏死（ONJ）的病例报道。本研究旨在描述接受双膦酸盐（BP）治疗的乳腺癌或妇科恶性肿瘤患者中ONJ的发生率及危险因素。
对1999年4月至2006年5月期间在图宾根大学医院妇产科接受静脉注射双膦酸盐治疗的所有乳腺癌或妇科恶性肿瘤患者的ONJ情况进行记录。
345例乳腺癌或妇科恶性肿瘤患者中，有10例（2.9%）在接受双膦酸盐治疗期间发生了ONJ。6例ONJ患者近期有牙科手术史。所有患者均接受了唑来膦酸作为其双膦酸盐治疗方案的一部分。双膦酸盐暴露时间和治疗周期数是ONJ发生的显著危险因素（p<0.001）。诊断为ONJ的患者平均治疗周期数为27±18个周期。然而，未出现ONJ的患者平均治疗周期数为12±12个周期。
双膦酸盐暴露时间和给定双膦酸盐的累积剂量似乎是ONJ发生的最重要危险因素，其次是牙科手术。
