Haidar Ali, Jønler Morten, Folkmar Troels B, Lund Lars
Department of Urology, Viborg County Hospital, Viborg, Denmark.
Scand J Urol Nephrol. 2009;43(6):442-4. doi: 10.3109/00365590903295193.
The use of bisphosphonates (zoledronic acid) in the treatment of metastatic bone disease has been raised during recent years. The purpose of this treatment is mainly to reduce skeletal-related events, e.g. pain and pathological fractures. The aim of this study was to report the incidence of bisphosphonate-related osteonecrosis of the jaw (ONJ).
All patients treated with bisphosphonates during a 5-year period (2003-2007) were reviewed.
Fifty-three patients, median age 69 years (range 56-81 years) were treated with bisphosphonates during the period. Fifty-one patients had hormone-refractory metastatic prostate cancer and two women had metastatic renal cell carcinoma. During this 5-year period, 686 treatments with bisphosphonates were administrated. The average treatment duration was 14 months (range 1-40 months) with administration of 4 mg of bisphosphonates every 4 weeks. Two cases of ONJ were registered. In the first case, the patient developed spontaneous osteonecrosis, whereas the second patient developed symptoms after a dental procedure. Since the initiation of a routine maxillofacial examination before treatment with bisphosphonates, no ONJ has been seen.
ONJ is a rare but a very serious complication in relation to treatment with bisphosphonates. To decrease the incidence of ONJ, a maxillofacial examination could be performed in all patients before treatment with bisphosphonates.
近年来，双膦酸盐类药物（唑来膦酸）在转移性骨病治疗中的应用日益增多。该治疗的主要目的是减少骨相关事件，如疼痛和病理性骨折。本研究旨在报告双膦酸盐相关颌骨坏死（ONJ）的发生率。
回顾了在5年期间（2003 - 2007年）接受双膦酸盐治疗的所有患者。
在此期间，53例患者接受了双膦酸盐治疗，中位年龄69岁（范围56 - 81岁）。51例患者患有激素难治性转移性前列腺癌，2例女性患有转移性肾细胞癌。在这5年期间，共进行了686次双膦酸盐治疗。平均治疗持续时间为14个月（范围1 - 40个月），每4周给予4毫克双膦酸盐。记录到2例ONJ病例。第一例患者发生自发性骨坏死，而第二例患者在牙科手术后出现症状。自从在双膦酸盐治疗前开始进行常规颌面检查以来，未再见到ONJ病例。
ONJ是双膦酸盐治疗中一种罕见但非常严重的并发症。为降低ONJ的发生率，在所有患者接受双膦酸盐治疗前可进行颌面检查。
