摘要
下颌骨坏死(ONJ)是一种罕见的治疗相关副作用,首先在2002年通过双膦酸盐(BPs)治疗转移性骨癌患者的病例报告中进行描述。 ONJ定义为八周或更长时间的口腔暴露骨的临床发现,没有对适当的治疗作出反应。诊断主要是临床诊断,但往往需要放射学确认与正畸。所以必须由具有足够的ONJ经验的牙科专家来做,需要对合并症和治疗史进行详细的遗传性探索。特别地,ONJ影响了用于骨转移性癌症的BPs治疗的大量肿瘤患者,以及最近的抗血管生成药物。本文的目的是描述这种罕见但严重的副作用及其病理生理学的诊断和分类。特别是,我们详细说明了抗血管生成药物与ONJ之间关系的临床证据。考虑到癌症流行病学发展与更多的癌症存活患者,这种副作用总是值得更多的关注。我们得出结论,当癌症患者必须开始BP或抗血管生成治疗时,ONJ必须经过深入研究和预防,涉及肿瘤学家,放射肿瘤学家和技术娴熟的牙科医生的多学科方法。
关键词: 颚骨坏死,双磷酸盐,血管生成,抗血管生成药物,抗VEGF,发病机制。
Current Medicinal Chemistry
Title:Osteonecrosis of the Jaw and Angiogenesis inhibitors: A Revival of a Rare but Serous Side Effect
Volume: 24 Issue: 28
关键词: 颚骨坏死,双磷酸盐,血管生成,抗血管生成药物,抗VEGF,发病机制。
摘要: Osteonecrosis of the jaw (ONJ) is a rare treatment related side effect that was firstly described in 2002 through a case report in metastatic bone cancer patient treated with bisphosphonates (BPs) therapy. ONJ is defined as an eight weeks or longer clinical finding of exposed bone in the oral cavity without response to appropriate therapy. The diagnosis is mainly clinical but often requires a radiological confirmation with an orthopantomography. So it must be made by a dental specialist with sufficient experience on ONJ and requires a detailed anamnestic exploration of comorbidities and treatments history. In particular, ONJ affects a wide number of oncologic patients treated with BPs for bone metastatic cancers and, more recently, with anti-angiogenic drugs. The aim of this this paper is to describe diagnosis and classification of this rare but serious side effect and its pathophysiology. In particular, we provide a detailed description of clinical evidences upon the relationship between anti-angiogenic drugs and ONJ. Considering the evolving of cancer epidemiology with a greater number of cancer surviving patients, this side effect always deserves more attention. We conclude that ONJ must be always carefully investigated and prevented with a multidisciplinary approach involving oncologist, radiation oncologist and skilled dental practitioner when a cancer patient must begin a BP or an antiangiogenic treatment.
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Cite this article as:
Osteonecrosis of the Jaw and Angiogenesis inhibitors: A Revival of a Rare but Serous Side Effect, Current Medicinal Chemistry 2017; 24 (28) . https://dx.doi.org/10.2174/0929867324666170511113811
DOI https://dx.doi.org/10.2174/0929867324666170511113811 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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