Combined antiresorptive and antiangiogenic therapy versus antiresorptive monotherapy: Impact on the surgical prognosis of MRONJ patients with advanced malignancies

IF 3.9 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone Pub Date : 2026-04-01 Epub Date: 2026-01-14 DOI:10.1016/j.bone.2026.117795

Yiwen Zou , Ning Zhao , Hongyuan Huang , Ying Zhou , Yuanning Yang , Qiao Qiao , Qingxiang Li , Jianhua Zhu , Yifei Wang , Yuxing Guo

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引用次数: 0

Abstract

For patients with advanced cancer and bone metastasis, antiresorptive medications (ARMs) and antiangiogenic medications (AGMs) are commonly employed to manage tumor progression and skeletal complications. This study evaluates the effects of distinct pharmacotherapeutic strategies—ARM monotherapy versus ARM+AGM combined therapy on surgical outcomes of medication-related osteonecrosis of the jaw (MRONJ) in this population.

A retrospective cohort analysis was conducted on 157 patients: 106 received ARM monotherapy, and 51 underwent combined ARM+AGM treatment. Demographic data, MRONJ clinical characteristics, and quality of life (QoL) metrics were systematically collected and analyzed using univariate and multivariate statistical methods.

Univariate analysis revealed that the ARM group had a higher proportion of females, longer antiresorptive therapy duration, and more favorable outcomes, including reduced postoperative pain and improved QoL compared to the ARM+AGM group. Multivariate analysis demonstrated that the ARM+AGM group exhibited a 2.8-fold recurrence risk relative to the ARM group, with prognosis significantly influenced by medication strategy, disease stage, and surgical approach.

These findings indicate that combined ARM+AGM therapy is associated with a poorer prognosis and heightened recurrence risk in MRONJ patients compared to ARM monotherapy.

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联合抗吸收和抗血管生成治疗与单一抗吸收治疗：对晚期恶性肿瘤MRONJ患者手术预后的影响。

对于晚期癌症和骨转移患者，抗吸收药物（ARMs）和抗血管生成药物（AGMs）通常用于控制肿瘤进展和骨骼并发症。本研究评估了不同的药物治疗策略-ARM单药治疗与ARM/AGM联合治疗对该人群药物相关性颌骨骨坏死（MRONJ）手术结果的影响。对157例患者进行回顾性队列分析：106例接受ARM单药治疗，51例接受ARM/AGM联合治疗。采用单变量和多变量统计方法系统收集和分析人口统计学数据、MRONJ特征和生活质量（QoL）指标。单因素分析显示，与ARM+AGM组相比，ARM组女性比例更高，抗吸收治疗持续时间更长，预后更佳，包括术后疼痛减轻和生活质量改善。多因素分析显示，与ARM组相比，ARM+AGM组的复发风险增加了2.8倍，其结果受药物治疗策略、疾病分期和手术方式的显著影响。这些发现表明，与ARM单药治疗相比，ARM+AGM联合治疗与MRONJ患者的预后较差和复发风险增加相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone 医学-内分泌学与代谢

CiteScore

8.90

自引率

4.90%

发文量

264

审稿时长

30 days

期刊介绍： BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.