Bissinger Oliver, Greiser Josefa, Maier Elisabeth, Ehrmann Philipp, Kakoschke Tamara, Wolff Klaus-Dietrich, Götz Carolin
Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstr. 35, Innsbruck, 6020, Austria.
Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany.
BMC Oral Health. 2025 Jun 21;25(1):951. doi: 10.1186/s12903-025-06171-3.
Medication-Related Osteonecrosis of the Jaw (MRONJ), an established side effect of antiresorptive and antiangiogenic medication, could sometimes require surgical intervention, such as decortication. The objectives of this retrospective patient survey study were to evaluate the effect of surgical treated MRONJ on health-related quality of life (QoL) and to assess the awareness of the risk of MRONJ.
The MRONJ-related QoL in both cancer and osteoporosis patients was determined in four different time periods after surgery applying the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), a modified version of the Module for Head and Neck Cancer (H&N35) and MRONJ-specific questions. In addition the patients´ awareness of the risk of MRONJ when being prescribed the medication was examined. 65 patients with MRONJ (28 males and 37 females) who underwent surgery of the jaw were included in this study.
In comparison to normative data of the German population cancer and osteoporosis patients showed a reduction in their QoL in general. It was demonstrated that MRONJ causes an even further negative impact, particularly on role and social function. Amongst the MRONJ patients certain factors such as female sex, breast cancer as underlying disease, hypothyroidism, denture, nicotine abuse and multiple surgeries of the MRONJ were associated with worse QoL. The majority of patients suffered from a lack of knowledge regarding the risk of MRONJ when starting antiresorptive or antiangiogenic treatment. Unaware patients manifested worse QoL results and had to undergo more operations.
QoL of MRONJ patients is deteriorated and the number of surgeries and the patients´ awareness have a significant impact on QoL. In order to reach better awareness amongst both patients, doctors and other health care professionals and to detect MRONJ at an earlier stage, the H&N35 and MRONJ specific questions should be routinely administered to osteoporosis and cancer patients when starting antiresorptive or antiangiogenic treatment.
颌骨药物相关性骨坏死（MRONJ）是抗吸收和抗血管生成药物已明确的副作用，有时可能需要手术干预，如去皮质术。这项回顾性患者调查研究的目的是评估手术治疗MRONJ对健康相关生活质量（QoL）的影响，并评估对MRONJ风险的认知。
采用欧洲癌症研究与治疗组织（EORTC）生活质量核心问卷（QLQ-C30）、头颈癌模块（H&N35）的修改版以及MRONJ特定问题，在术后四个不同时间段确定癌症和骨质疏松症患者中与MRONJ相关的生活质量。此外，还检查了患者在开具药物时对MRONJ风险的认知。本研究纳入了65例接受颌骨手术的MRONJ患者（28例男性和37例女性）。
与德国人群的标准数据相比，癌症和骨质疏松症患者的生活质量总体下降。结果表明，MRONJ会造成更严重的负面影响，尤其是对角色和社会功能。在MRONJ患者中，某些因素如女性、潜在疾病为乳腺癌、甲状腺功能减退、义齿、尼古丁滥用以及MRONJ的多次手术与较差的生活质量相关。大多数患者在开始抗吸收或抗血管生成治疗时对MRONJ风险缺乏了解。未意识到风险的患者生活质量结果较差，且不得不接受更多手术。
MRONJ患者的生活质量下降，手术次数和患者认知对生活质量有显著影响。为了提高患者、医生和其他医护人员的认知，并在更早阶段发现MRONJ，在开始抗吸收或抗血管生成治疗时，应常规对骨质疏松症和癌症患者使用H&N35和MRONJ特定问题进行评估。
