Scholarlink

Purpose <p>Discontinuing bone-modifying agents (BMAs) during management of medication-related osteonecrosis of the jaw (MRONJ) remains controversial. This retrospective study evaluates the impact and potential risks of BMA drug holidays in cancer patients with MRONJ.</p> Methods <p>We retrospectively classified 156 cancer patients with MRONJ into four groups: BMA withdrawal with conservative therapy (WC, <i>n</i> = 40), withdrawal with surgical therapy (WS, <i>n</i> = 63), non-withdrawal with conservative therapy (nWC, <i>n</i> = 30), and non-withdrawal with surgical therapy (nWS, <i>n</i> = 23). In the WS group, surgery was performed after radiographic confirmation of bone sequestration following BMA discontinuation. Healing rates and skeletal-related events (SREs) incidence were analyzed.</p> Results <p>The healing rates from MRONJ onset were 94.7% in the WS group, 53.6% in the nWS group, 25.5% in the WC group, and 0% in the nWC group. Among surgical patients, the healing rate from the time of surgery was significantly higher in the WS group (92.3%) than in the nWS group (47.8%) (hazard ratio = 3.23, <i>p</i> &lt; 0.05). The incidence of SREs was 52.3% in the WC group, 15.8% in the WS group, 16.7% in the nWS group, and 4.2% in the nWC group. The WC group showed a significantly higher incidence of SREs compared with the WS and nWS groups.</p> Conclusion <p>A therapeutic strategy involving planned BMA discontinuation followed by delayed surgical intervention after radiographic confirmation of sequestrum formation, may be associated with improved healing outcomes. This approach does not appear to increase the incidence of SREs, particularly when BMA therapy is appropriately resumed after successful surgical healing.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Efficacy and risks of drug holiday in the management of medication-related osteonecrosis of the jaw in cancer patients: a single-center retrospective study

  • 期刊论文

  • 发表日期：

    2026年1月14日

查看全文
  • Hironobu Hata,
  • Kenji Imamachi,
  • Kazuhito Yoshikawa,
  • Mayumi Kamaguchi,
  • Toshihisa Osanai,
  • Masashi Matsuzaka,
  • Kenichi Watanabe,
  • Nobumoto Tomioka,
  • Toru Harabayashi,
  • Katsuya Fujimoto,
  • Satoshi Oizumi,
  • Michihiro Ueda,
  • Hiroaki Hiraga,
  • Ikuya Miyamoto

摘要

Purpose

Discontinuing bone-modifying agents (BMAs) during management of medication-related osteonecrosis of the jaw (MRONJ) remains controversial. This retrospective study evaluates the impact and potential risks of BMA drug holidays in cancer patients with MRONJ.

Methods

We retrospectively classified 156 cancer patients with MRONJ into four groups: BMA withdrawal with conservative therapy (WC, n = 40), withdrawal with surgical therapy (WS, n = 63), non-withdrawal with conservative therapy (nWC, n = 30), and non-withdrawal with surgical therapy (nWS, n = 23). In the WS group, surgery was performed after radiographic confirmation of bone sequestration following BMA discontinuation. Healing rates and skeletal-related events (SREs) incidence were analyzed.

Results

The healing rates from MRONJ onset were 94.7% in the WS group, 53.6% in the nWS group, 25.5% in the WC group, and 0% in the nWC group. Among surgical patients, the healing rate from the time of surgery was significantly higher in the WS group (92.3%) than in the nWS group (47.8%) (hazard ratio = 3.23, p < 0.05). The incidence of SREs was 52.3% in the WC group, 15.8% in the WS group, 16.7% in the nWS group, and 4.2% in the nWC group. The WC group showed a significantly higher incidence of SREs compared with the WS and nWS groups.

Conclusion

A therapeutic strategy involving planned BMA discontinuation followed by delayed surgical intervention after radiographic confirmation of sequestrum formation, may be associated with improved healing outcomes. This approach does not appear to increase the incidence of SREs, particularly when BMA therapy is appropriately resumed after successful surgical healing.