title: Decreasing frequency of osteonecrosis of the jaw in cancer and myeloma patients treated with bisphosphonates: the experience of the oncology network of piedmont and aosta valley (north-Western Italy).
abstract: Background. Data concerning frequency of Osteonecrosis of Jaws (ONJ) are mostly based on single center experiences. Patients and Methods. Since 2005 a multidisciplinary study group collected data of cases of ONJ in patients treated with Bisphosphonates (BP) and observed in oncology and hematology centers of a regional network. Results. By December 2008, 221 cases were registered. We report details of 200 cases, identified after cross-checking reports from centres of medical oncology, haematology, and oral care. Primary neoplasm was breast cancer (39%), myeloma (32%), prostate cancer (16%), and other types of cancer (8%). In about 50% of the cases a history of dental extraction was present. Zoledronic acid was administered (alone or with other BP) to 178 patients (89%). Median time from first infusion to ONJ diagnosis was 21.0 (zoledronic acid only) and 39.0 months (pamidronate only). The number of ONJ cases per year was 3 in 2003, 21 in 2004, 58 in 2005, 60 in 2006, 37 in 2007, and 21 in 2008. Conclusion. The number of new ONJ cases in cancer and myeloma patients increased until 2006 and then reduced. The possible reasons of this trend (introduction of zoledronic acid; increase of ONJ awareness; diffusion of preventive dental measures; late modifications of BP prescription) are herein discussed.
authors.affiliation: Medical Oncology Unit, Department of Oncology and Hematology, Ospedale SS Antonio e Biagio e C Arrigo, Via Venezia 16, 15121 Alessandria, Italy.
authors.forename: Vittorio
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authors.lastname: Fusco
authors.forename: Claudia
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authors.lastname: Galassi
authors.forename: Alfredo
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authors.lastname: Berruti
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.forename: Libero
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authors.lastname: Ciuffreda
authors.forename: Matteo
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authors.lastname: Scoletta
authors.forename: Franco
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authors.lastname: Goia
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authors.lastname: Migliario
authors.forename: Anna
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authors.lastname: Baraldi
authors.forename: Mario
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authors.lastname: Boccadoro
authors.forename: Anastasios
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authors.lastname: Loidoris
authors.forename: Oscar
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authors.lastname: Bertetto