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唑来膦酸治疗下骨转移乳腺癌和前列腺癌相关颌骨骨坏死的风险因素:10 年评估的回顾性分析。

Risk Factors for Bisphosphonate-Related Osteonecrosis of the Jaws in Bone Metastatic Breast and Prostate Cancer under Zoledronate Treatment: A Retrospective Analysis from 10 Years of Evaluation.

机构信息

Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.

Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil.

出版信息

Asian Pac J Cancer Prev. 2023 Aug 1;24(8):2681-2689. doi: 10.31557/APJCP.2023.24.8.2681.

Abstract

OBJECTIVE

This study aims to analyze the risk factors for BRONJ in patients taking zoledronic acid (ZA) for metastatic breast and prostate cancer.

METHODS

For this, a retrospective, quantitative, observational cohort study was conducted using data on adverse effects in the oral cavity in patients during chemotherapy for treatment of solid tumors available in the electronic patient record system of the Haroldo Juaçaba Hospital/Ceará Cancer Institute in the period from 2010, to 2019. Data were tabulated in Excel and exported to SPSS v20.0 software for statistical analysis, with 95% confidence.

RESULTS

Thus, it can be observed that the prevalence of BRONJ in patients under treatment for breast cancer and prostate cancer was <7%, with age <50 years of age (p=0.009), cytotoxic chemotherapy such as methotrexate (p=0.023), paclitaxel (p=0.005), capecitabine (p<0.001), gemcitabine (p=0.007) and bicalutamide (p=0.016), amount of ZA infusions (p<0.001) and hormone therapy (p=0.007), in addition, a slight reduction in survival and increased use of antidepressants (p=0.014) were observed. The reduced overall survival and increased use of antidepressants in patients who developed BRONJ, reinforcing the need for further research to study the mechanisms involved in the unconventional risk factors for BRONJ.

CONCLUSION

Thus, increasing the attention to these patients to prevent this condition from compromising the prognosis of these individuals.

摘要

目的

本研究旨在分析接受唑来膦酸(ZA)治疗转移性乳腺癌和前列腺癌患者发生 BRONJ 的风险因素。

方法

为此,我们进行了一项回顾性、定量、观察性队列研究,使用了 Haroldo Juaçaba 医院/塞阿拉癌症研究所电子病历系统中 2010 年至 2019 年期间治疗实体瘤化疗期间口腔不良反应的数据。数据以 Excel 表格形式列出,并导入 SPSS v20.0 软件进行统计分析,置信区间为 95%。

结果

因此,可以观察到乳腺癌和前列腺癌治疗患者的 BRONJ 患病率<7%,年龄<50 岁(p=0.009)、细胞毒性化疗药物如甲氨蝶呤(p=0.023)、紫杉醇(p=0.005)、卡培他滨(p<0.001)、吉西他滨(p=0.007)和比卡鲁胺(p=0.016)、ZA 输注量(p<0.001)和激素治疗(p=0.007),此外,观察到生存率略有降低和抗抑郁药使用增加(p=0.014)。BRONJ 患者的总体生存率降低和抗抑郁药使用增加,这加强了需要进一步研究来研究 BRONJ 非常规风险因素所涉及的机制。

结论

因此,需要更加关注这些患者,以防止这种情况影响这些个体的预后。

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