Expected survival of cancer patients and myeloma undergoing bisphosphonates or denosumab. Potential impact on diagnosis and management of Osteonecrosis of Jaws (ONJ)

IF 0.1 3区艺术学 0 MUSIC

MUSICAL QUARTERLY Pub Date : 2021-04-11 DOI:10.32388/MQ2IYG

V. Fusco, M. Cabras, A. Gambino, M. Di Maio, R. Freilone, M. Tampellini, I. Romaniello, M. R. Alvaro, G. Numico, M. Rossi, C. Ortega, M. Tucci, D. Ottaviani, L. Buffoni, G. Scagliotti, G. Vellani, P. Varese, M. Franchini, C. Galassi

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引用次数: 1

Abstract

Survival of cancer and myeloma patients after diagnosis of bone lesions is largely variable. Appropriate medical therapy together with antiresorptive treatment (bisphosphonates or denosumab) can obtain prolonged survival with adequate quality of life. Osteonecrosis of Jaws (ONJ) is not rare in patients with bone metastatic cancer and myeloma patients, occurring mostly after prolonged antiresorptive treatment. Expected survival can influence the choice of antiresorptive treatment, the perception of ONJ risk, and even the ONJ management. We reviewed survival data after start of antiresorptive treatment of 509 ONJ patients registered in a cancer network database (Rete Oncologica Piemonte-Valle d’Aosta, North-Western Italy). Main characteristics: 196 males, 313 females; median age: 68 (39-89) years. Underlying disease: breast cancer: 42.9%; myeloma: 25.3%; prostate cancer: 17.2%; lung cancer: 6.7%; renal cancer: 2.5%; other cancer types: 4.3%. Main antiresorptive treatment: zoledronic acid: 79.4%; denosumab: 5.3%; other drugs/sequences: 15.3%. Actuarial median survival (range) after the start of antiresorptive treatment was 66.0 (95% CI 57-77) months for breast cancer patients, 77.3 (95% CI 61.9-86.8) months for myeloma patients, 47.3. (95% CI 37.8-51.9) months for prostate cancer patients, 29.4 (95% CI 20.4-40.1) months for lung cancer patients, 39.4 (95% CI 20-107.3) months for renal cancer patients, 82.4 (95% CI 51.9-150.9) months for other cancer patients. Two-, three- and four-year actuarial survival rates were respectively 91.7%%, 80.2%, 67.4% for breast cancer patients, 91.4%, 83.7%, 68.9% for myeloma patients, 78.4%, 61.2%, 41.9% for prostate cancer patients; 55.8%, 32.3%, 23.5% for lung cancer patients; 61.5%, 53.8%, 46.1% for renal cancer patients; 81.8%, 77.3%, 68.1% for others cancer types. Our data support careful evaluation of short and long-term actuarial ONJ risk (versus short-term absolute risk) in the choice of antiresorptive treatment duration for bone metastatic cancer and myeloma patients. Furthermore, exclusion of jawbone surgery due to expected short survival in most of ONJ patients seems not warranted.

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癌症和骨髓瘤患者接受双膦酸盐或替诺沙单抗治疗的预期存活率。对颌骨骨坏死（ONJ）诊断和治疗的潜在影响

癌症和骨髓瘤患者在诊断为骨病变后的生存率在很大程度上是可变的。适当的药物治疗加上抗再吸收治疗（双膦酸盐或狄诺沙单抗）可以延长生存期，并提供足够的生活质量。颌骨骨坏死（ONJ）在骨转移性癌症和骨髓瘤患者中并不罕见，主要发生在长期抗再吸收治疗后。预期生存期可以影响抗再吸收治疗的选择、对ONJ风险的感知，甚至ONJ的管理。我们回顾了在癌症网络数据库（Rete Oncologica Piemonte-Valle d‘Aosta，意大利西北部）中注册的509名ONJ患者开始抗再吸收治疗后的生存数据。主要特征：男性196人，女性313人；中位年龄：68岁（39-89岁）。基础疾病：乳腺癌症：42.9%；骨髓瘤：25.3%；前列腺癌症：17.2%；癌症6.7%；癌症：2.5%；其他癌症类型：4.3%。主要抗再吸收治疗：唑来膦酸：79.4%；狄诺沙单抗：5.3%；其他药物/序列：15.3%。开始抗再吸收治疗后，癌症患者的实际中位生存期（范围）为66.0个月（95%CI 57-77），骨髓瘤患者为77.3个月（95%CI 61.9-86.8），47.3个月。前列腺癌症患者为（95%CI 37.8-51.9）个月，癌症患者为29.4（95%CI 20.4-4.0.1）个月；癌症患者为39.4（95%CI20-107.3）个月。癌症患者的2年、3年和4年精算生存率分别为91.7%、80.2%、67.4%，骨髓瘤患者为91.4%、83.7%、68.9%，癌症前列腺患者为78.4%、61.2%、41.9%；癌症患者分别为55.8%、32.3%、23.5%；癌症患者分别为61.5%、53.8%、46.1%；其他癌症类型分别为81.8%、77.3%、68.1%。我们的数据支持在选择骨转移性癌症和骨髓瘤患者的抗再吸收治疗持续时间时仔细评估短期和长期精算ONJ风险（相对于短期绝对风险）。此外，由于大多数ONJ患者的预期生存期较短，因此排除颚骨手术似乎没有必要。

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

MUSICAL QUARTERLY MUSIC-

CiteScore

0.30

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0.00%

发文量

期刊介绍： The Musical Quarterly, founded in 1915 by Oscar Sonneck, has long been cited as the premier scholarly musical journal in the United States. Over the years it has published the writings of many important composers and musicologists, including Aaron Copland, Arnold Schoenberg, Marc Blitzstein, Henry Cowell, and Camille Saint-Saens. The journal focuses on the merging areas in scholarship where much of the challenging new work in the study of music is being produced.