악성 골종양 환자에 발생한 BRONJ의 임상적 고찰 = Clinical investigation of Bisphosphonate-Related Osteonecrosis of The Jaws in patients with malignant bone tumor

다국어 초록 (Multilingual Abstract)

PURPOSE : Through the analysis of serological values and clinical aspects of the cancer patients with malignant bone tumor in Korea, we'd like to find out the way of BRONJ diagnosis and the method of BRONJ treatment.
MATERIAL and METHOD : Among those who were referred to the Department of Oral and Maxillofacial surgery in Kyungpook University Dental Hospital and who met the BRONJ criteria of American Association of Oral and Maxillofacial Surgeons (AAOMS), twenty-one cancer patients(12 of multiple myeloma, 7 of breast cancer, and 2 of prostate cancer) are selected. And 5 factors(erythrocyte sedimentation rate: ESR, c-reactive protein: CRP, alkaline phosphatease: ALP, osteocalcin: OCN, c-termainal cross-link telopeptide: CTX) were measured and compared with those of normal values.
RESULTS : 1. Among the patients with malignant bone tumor, the BRONJ occurred more frequently in patients with multiple myeloma(12persons, 57.1%). The average time to BRONJ was 35.0±19.0 months. The risk factors of BRONJ were the extraction(14 persons, 67%) and improper denture use(4 persons, 20%).
2. Mandible was more susceptible to BRONJ than maxilla, as posterior was to anterior. When BRONJ was diagnosed, BRONJ stage of the selected patients were stage I(2 persons, 9%), stage II(13 persons, 62%), and stage III(6 persons, 29%).
3. The differences between the recurred patients and non-recurred patients in the values of ESR, CRP, and CTX were not noticed. But the statement is not statistically convincing, as the number of selected patients was not large enough. The higher the stage of BRONJ, the lower the value of CTX.
4. During the treatment of BRONJ, some patients discontinued the use of BPs and the others didn't. The investigation was made in order to find out the differences between two groups. The result showed no differences in the aspect of disease and/or recurrence frequencies (p>0.05). It is a matter for consideration that drug holiday to BRONJ patients should be necessary.
CONCLUSION : Among the cancer patients with malignant bone tumor, BRONJ occurred more frequently in patients with multiple myeloma and was more susceptible to mandible than maxilla. During the treatment of BRONJ, some patients discontinued the use of BPs and the others didn't. The investigation was made in order to find out the differences between two groups. The result showed no differences in the aspect of disease and/or recurrence frequencies (p>0.05). The differences between the recurred patients and non-recurred patients in the values of ESR, CRP, and CTX were not noticed. But the statement is not statistically convincing, as the number of selected patients was not large enough.

목차 (Table of Contents)

• I. 서론 1
• II. 연구 대상 및 방법 3
• III. 결과 4
• IV. 고찰 7
• V. 결론 12