Turner Bruce, Drudge-Coates Lawrence, Ali Sacha, Pati Jhumur, Nargund Vinod, Ali Enamul, Cheng Leo, Wells Paula
Urol Nurs. 2016 May-Jun;36(3):111-6, 154.
Urologic patients receiving bone-targeted therapies are at risk of developing osteonecrosis of the jaw (ONJ). ONJ has historically been associated with bisphosphonate therapy. More recently, RANK-Ligand inhibitors (denosumab) have also been used to reduce the risk of skeletal-related events in patients who have advanced cancers with bone metastases. More than 65% of men with metastatic prostate cancer and nearly 75% of women with metastatic breast cancer are affected by bone metastases. The literature has described ONJ associated with bisphosphonate therapy as bisphosphonate-related osteonecrosis of the jaw (BRONJ). However, with evidence also linking the use of RANK-Ligand inhibitors with osteonecrosis of the jaw, we advocate use of the term "anti-bone resorption therapy-related osteonecrosis of the jaw" (ABRT-ONJ). The term "medication-related osteonecrosis of the jaw" (MRONJ) is now becoming more widespread. There is not a universally accepted definition of ABRT-ONJ, which may have hindered recognition and reporting of the condition. In Part I of this article, a review of current knowledge around the etiology of ABRT-ONJ and incidence data are provided. In Part II, we provide an audit of ONJ in a nurse consultant-led bone support clinic. In the article, we refer to zoledronic acid because this is the bisphosphonate of choice for use in men with prostate cancer in the United Kingdom.
接受骨靶向治疗的泌尿科患者有发生颌骨坏死（ONJ）的风险。历史上，ONJ一直与双膦酸盐治疗有关。最近，RANK配体抑制剂（地诺单抗）也被用于降低患有晚期骨转移癌患者发生骨相关事件的风险。超过65%的转移性前列腺癌男性患者和近75%的转移性乳腺癌女性患者受到骨转移的影响。文献中已将与双膦酸盐治疗相关的ONJ描述为双膦酸盐相关颌骨坏死（BRONJ）。然而，有证据表明使用RANK配体抑制剂也与颌骨坏死有关，我们主张使用“抗骨吸收治疗相关颌骨坏死”（ABRT-ONJ）这一术语。“药物相关颌骨坏死”（MRONJ）这一术语现在越来越普遍。目前尚无ABRT-ONJ的普遍接受的定义，这可能阻碍了对该病症的识别和报告。在本文的第一部分，对ABRT-ONJ病因的现有知识和发病率数据进行了综述。在第二部分，我们对由护士顾问主导的骨支持诊所中的ONJ情况进行了审核。在本文中，我们提及唑来膦酸，因为这是英国用于前列腺癌男性患者的首选双膦酸盐。
