PDF(Pubmed)
Abstract：
Bone-modifying agents (BMAs) are integral to managing patients with advanced cancer. They improve quality of survival by reducing skeletal-related events, treating hypercalcaemia and chemotherapy-induced bone loss (Coleman in Clin Cancer Res 12: 6243s-6249s, 2006), (Coleman in Ann Oncol 31: 1650-1663, 2020). Two decades ago, medication-related osteonecrosis of the jaw (MRONJ) was first reported following BMA therapy (Marx in J Oral Maxillofac Surg 61: 1115-1117, 2003). The risk of MRONJ extends over a decade following BMA treatment with bisphosphonates, complicating dental care such as extractions. In addition, MRONJ has been reported following additional therapies such as antiangiogenic agents, cytotoxic agents, immunotherapy, and targeted agents. The use of BMAs in the curative and adjuvant cancer setting is increasing, consequently the implication of MRONJ is growing. Over the past 20 years, the literature has consolidated major risk factors for MRONJ, the pathophysiology and management strategies for MRONJ. Our review aims to document the development of MRONJ preventative and management strategies in cancer patients receiving a BMA. The authors advocate the incorporation of dental oncology strategies into contemporary cancer care, to optimise long-term quality of survival after cancer treatment.
摘要：
骨调节剂（BMAs）是治疗晚期癌症患者不可或缺的一部分。它们通过减少骨骼相关事件来提高生存质量，治疗高钙血症和化疗引起的骨丢失（ColemaninClinCancerRes12：6243s-6249s，2006),（科尔曼在安·奥科尔31：1650-1663，2020年）。二十年前,药物相关的颌骨坏死（MRONJ）在BMA治疗后首次报道（MarxinJOralMaxillofacSurg61：1115-1117，2003）。MRONJ的风险在BMA用双膦酸盐治疗后超过十年，复杂的牙齿护理，如拔牙。此外,据报道，MRONJ在其他疗法如抗血管生成药物之后，细胞毒性剂，免疫疗法，和有针对性的特工。BMA在治愈性和辅助性癌症环境中的使用正在增加，因此，MRONJ的含义越来越大。在过去的20年里,文献已经巩固了MRONJ的主要风险因素，MRONJ的病理生理学和管理策略。我们的综述旨在记录MRONJ预防和管理策略在接受BMA的癌症患者中的发展。作者主张将牙科肿瘤学策略纳入当代癌症护理中，优化癌症治疗后的长期生存质量。
