Hyperbaric Oxygen Treatment and Bisphosphonate-Induced Osteonecrosis of the Jaw: A Case Series
| Autor: | Austin H. Chhoeu, Otto Boneta, Richard E. Moon, John J. Freiberger, Rebecca Padilla-Burgos, Claude A. Piantadosi, Kevin H. Kraft |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Breast Neoplasms Kaplan-Meier Estimate Malignancy Hyperbaric oxygen medicine Humans Symptom onset Stage (cooking) Aged Hyperbaric Oxygenation Bone Density Conservation Agents Diphosphonates business.industry Remission Induction Osteonecrosis Middle Aged Bisphosphonate medicine.disease Confidence interval Surgery Logistic Models Otorhinolaryngology Female Oral Surgery Multiple Myeloma business Osteonecrosis of the jaw Jaw Diseases After treatment |
| Zdroj: | Journal of Oral and Maxillofacial Surgery. 65:1321-1327 |
| ISSN: | 0278-2391 |
| DOI: | 10.1016/j.joms.2007.03.019 |
| Popis: | Purpose Bisphosphonate (BP)-associated osteonecrosis of the jaw (ONJ) is an emerging problem with few therapeutic options. Our pilot study of BP-ONJ investigated a possible role for hyperbaric oxygen (HBO 2 ) therapy. Patients and Methods A total of 16 patients, ranging in age from 43 to 78 years, with BP-ONJ were treated with adjunctive HBO 2 between July 2003 and April 2006. Staging was based on the size and number of oral lesions. Clinical response after treatment and at distant follow-up; the odds of remission, stabilization, or relapse; and time to failure analysis were calculated. Results The median time on BP therapy before appearance of ONJ symptoms was 18 months, and that from symptom onset to HBO 2 therapy was 12 months. Fourteen of 16 patients (87.5%) improved in stage. The size and number of ONJ lesions were decreased after HBO 2 therapy ( P P = .008, respectively; Wilcoxon signed-rank test). Immediately after HBO 2 therapy, 7 of 16 patients (44%) were in remission and 8 (50%) had stabilized; however, stabilization without remission was sustained in only 2 patients. At follow-up, 10 of the patients (62.5%) were still in remission or had stabilized. The 7 patients who continued on BP treatment during HBO 2 therapy had a shorter time to failure (8.5 months; 95% confidence interval [CI] = 7.1 to 9.8) than those who discontinued the drug (20.1 months; 95% CI = 17.5 to 23.9; P = .006 by the log-rank test). Clinical response was not associated with cancer type or malignancy remission status. Conclusions Adjunctive HBO 2 therapy may benefit patients with BP-ONJ; however, the outcome is improved with cessation of BP administration. |
| Databáze: | OpenAIRE |
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