Stomatology Department, School of Dentistry, São Paulo University, São Paulo, Brazil.
Stomatology Department, A.C. Camargo Cancer Center, São Paulo, Brazil.
Oral Dis. 2019 Jul;25(5):1344-1351. doi: 10.1111/odi.13081. Epub 2019 Mar 26.
Osteoradionecrosis (ORN) is one of the most severe adverse effects of radiotherapy (RT) to the head and neck region. Medication-induced osteonecrosis of the jaw has been reported among patients using bisphosphonates. However, the impact of RT on osteonecrosis in patients using bisphosphonates has not yet been described. Therefore, the aim of this study was to compare ORN characteristics between patients who use and do not use bisphosphonates.
This retrospective study evaluated 96 patients with ORN of the jaw. Patients were divided into group I (patients who did not receive bisphosphonates, n = 83) and group II (patients who did receive bisphosphonates, n = 13). Clinical data were obtained from medical charts.
Osteoradionecrosis more often involved the mandibular jaw than the maxillary jaw for both patient groups. However, maxillary involvement was more common among patients who received bisphosphonates than those who did not (p = 0.014). There was also a trend toward earlier development of ORN in the group that received bisphosphonates (p = 0.21).
Bisphosphonate use appears to contribute to earlier development of ORN. Long-term prospective studies are needed to understand the pathogenesis of ORN in patients treated with combined radiation and bisphosphonate therapy.
放射性骨坏死（ORN）是头颈部放射治疗（RT）最严重的不良反应之一。有报道称，接受双膦酸盐治疗的患者会发生药物诱导性下颌骨坏死。然而，接受双膦酸盐治疗的患者的 RT 对骨坏死的影响尚未描述。因此，本研究旨在比较使用和不使用双膦酸盐的患者的 ORN 特征。
本回顾性研究评估了 96 例颌骨 ORN 患者。患者分为 I 组（未接受双膦酸盐治疗的患者，n=83）和 II 组（接受双膦酸盐治疗的患者，n=13）。临床数据来自病历。
两组患者的 ORN 均更常累及下颌骨而非上颌骨，但接受双膦酸盐治疗的患者中上颌骨受累更为常见（p=0.014）。接受双膦酸盐治疗的患者 ORN 发病更早，这一趋势具有统计学意义（p=0.21）。
双膦酸盐的使用似乎会导致 ORN 更早发生。需要进行长期前瞻性研究，以了解接受放疗和双膦酸盐联合治疗的患者 ORN 的发病机制。
