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Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Prostate Cancer | Research

The trend of dental check-up and prevalence of dental complications following the use of bone modifying agents in patients with metastatic breast and prostate cancer: analysis of data from the Korean National Health Insurance Service

Authors: Ah Reum Lim, Wonse Park, Seok Joo Moon, Min Sun Kim, Soohyeon Lee

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

Bone-modifying agents (BMA) are key components in the management of cancer patients with bone metastasis. Despite their clinical benefits, the use of BMA is associated with dental adverse events (AEs) including medication-related osteonecrosis of the jaw (MRONJ). This study investigated the frequency of dental surveillance before BMA treatment and the prevalence of dental AEs including MRONJ, after BMA treatment in patients with bone metastasis from breast and prostate cancer using data from the national health insurance system.

Methods

Data, including age, cancer diagnosis, administered BMA, and dental AEs during cancer treatment, of patients with bone metastasis from breast and prostate cancer who received at least one infusion of BMA between 2007 and 2019 were extracted from the Korean National Health Insurance Service (KNHIS) dataset.

Results

Of the 15,357 patients who received BMA, 1,706 patients (11.1%) underwent dental check-ups before BMA treatment. The proportion of patients receiving dental check-up increased from 4.4% in 2007 to 16.7% in 2019. Referral to dentists for a dental check-up was more active in clinics/primary hospitals than general/tertiary hospitals, and medical doctors and urologists actively consulted to dentists than general surgeons, regardless of the patient’s health insurance status. After BMA treatment, 508 patients (3.8%) developed dental AEs, including abscess (42.9%), acute periodontitis (29.7%), acute pericoronitis (14.9%), and MRONJ (12.5% of dental AEs cases, 0.5% of total BMA treated patients).

Conclusions

Considering the long treatment period in patients with metastatic cancer, coordination between dentists and oncologists is necessary to ensure appropriate dental management before the initiation of BMA.
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Literature
1.
go back to reference Coleman R, Body JJ, Aapro M, Hadji P, Herrstedt J. Bone health in cancer patients: ESMO Clinical Practice guidelines. Ann Oncol. 2014;25(Suppl 3):iii124–37.CrossRefPubMed Coleman R, Body JJ, Aapro M, Hadji P, Herrstedt J. Bone health in cancer patients: ESMO Clinical Practice guidelines. Ann Oncol. 2014;25(Suppl 3):iii124–37.CrossRefPubMed
2.
go back to reference Aapro M, Abrahamsson PA, Body JJ, Coleman RE, Colomer R, Costa L, et al. Guidance on the use of bisphosphonates in solid tumours: recommendations of an international expert panel. Ann Oncol. 2008;19:420–32.CrossRefPubMed Aapro M, Abrahamsson PA, Body JJ, Coleman RE, Colomer R, Costa L, et al. Guidance on the use of bisphosphonates in solid tumours: recommendations of an international expert panel. Ann Oncol. 2008;19:420–32.CrossRefPubMed
3.
go back to reference Hortobagyi GN, Theriault RL, Lipton A, Porter L, Blayney D, Sinoff C, et al. Long-term prevention of skeletal complications of metastatic breast cancer with pamidronate. Protocol 19 aredia breast Cancer Study Group. J Clin Oncol. 1998;16:2038–44.CrossRefPubMed Hortobagyi GN, Theriault RL, Lipton A, Porter L, Blayney D, Sinoff C, et al. Long-term prevention of skeletal complications of metastatic breast cancer with pamidronate. Protocol 19 aredia breast Cancer Study Group. J Clin Oncol. 1998;16:2038–44.CrossRefPubMed
4.
go back to reference Saad F, Gleason DM, Murray R, Tchekmedyian S, Venner P, Lacombe L, et al. Long-term efficacy of zoledronic acid for the prevention of skeletal complications in patients with metastatic hormone-refractory prostate cancer. J Natl Cancer Inst. 2004;96:879–82.CrossRefPubMed Saad F, Gleason DM, Murray R, Tchekmedyian S, Venner P, Lacombe L, et al. Long-term efficacy of zoledronic acid for the prevention of skeletal complications in patients with metastatic hormone-refractory prostate cancer. J Natl Cancer Inst. 2004;96:879–82.CrossRefPubMed
6.
go back to reference Rosen LS, Gordon D, Kaminski M, Howell A, Belch A, Mackey J, et al. Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial. Cancer J. 2001;7:377–87.PubMed Rosen LS, Gordon D, Kaminski M, Howell A, Belch A, Mackey J, et al. Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial. Cancer J. 2001;7:377–87.PubMed
7.
go back to reference Rosen LS, Gordon D, Tchekmedyian NS, Yanagihara R, Hirsh V, Krzakowski M, et al. Long-term efficacy and safety of zoledronic acid in the treatment of skeletal metastases in patients with nonsmall cell lung carcinoma and other solid tumors: a randomized, phase III, double-blind, placebo-controlled trial. Cancer. 2004;100:2613–21.CrossRefPubMed Rosen LS, Gordon D, Tchekmedyian NS, Yanagihara R, Hirsh V, Krzakowski M, et al. Long-term efficacy and safety of zoledronic acid in the treatment of skeletal metastases in patients with nonsmall cell lung carcinoma and other solid tumors: a randomized, phase III, double-blind, placebo-controlled trial. Cancer. 2004;100:2613–21.CrossRefPubMed
8.
go back to reference Himelstein AL, Foster JC, Khatcheressian JL, Roberts JD, Seisler DK, Novotny PJ, et al. Effect of Longer-Interval vs Standard Dosing of Zoledronic Acid on skeletal events in patients with bone metastases: a Randomized Clinical Trial. JAMA. 2017;317:48–58.CrossRefPubMedPubMedCentral Himelstein AL, Foster JC, Khatcheressian JL, Roberts JD, Seisler DK, Novotny PJ, et al. Effect of Longer-Interval vs Standard Dosing of Zoledronic Acid on skeletal events in patients with bone metastases: a Randomized Clinical Trial. JAMA. 2017;317:48–58.CrossRefPubMedPubMedCentral
9.
go back to reference Vahtsevanos K, Kyrgidis A, Verrou E, Katodritou E, Triaridis S, Andreadis CG, et al. Longitudinal cohort study of risk factors in cancer patients of bisphosphonate-related osteonecrosis of the jaw. J Clin Oncol. 2009;27:5356–62.CrossRefPubMed Vahtsevanos K, Kyrgidis A, Verrou E, Katodritou E, Triaridis S, Andreadis CG, et al. Longitudinal cohort study of risk factors in cancer patients of bisphosphonate-related osteonecrosis of the jaw. J Clin Oncol. 2009;27:5356–62.CrossRefPubMed
10.
go back to reference Stopeck AT, Fizazi K, Body JJ, Brown JE, Carducci M, Diel I, et al. Safety of long-term denosumab therapy: results from the open label extension phase of two phase 3 studies in patients with metastatic breast and prostate cancer. Support Care Cancer. 2016;24:447–55.CrossRefPubMed Stopeck AT, Fizazi K, Body JJ, Brown JE, Carducci M, Diel I, et al. Safety of long-term denosumab therapy: results from the open label extension phase of two phase 3 studies in patients with metastatic breast and prostate cancer. Support Care Cancer. 2016;24:447–55.CrossRefPubMed
11.
go back to reference Qi WX, Tang LN, He AN, Yao Y, Shen Z. Risk of osteonecrosis of the jaw in cancer patients receiving denosumab: a meta-analysis of seven randomized controlled trials. Int J Clin Oncol. 2014;19:403–10.CrossRefPubMed Qi WX, Tang LN, He AN, Yao Y, Shen Z. Risk of osteonecrosis of the jaw in cancer patients receiving denosumab: a meta-analysis of seven randomized controlled trials. Int J Clin Oncol. 2014;19:403–10.CrossRefPubMed
12.
go back to reference Hong CHL, Gueiros LA, Fulton JS, Cheng KKF, Kandwal A, Galiti D, et al. Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019;27:3949–67.CrossRefPubMed Hong CHL, Gueiros LA, Fulton JS, Cheng KKF, Kandwal A, Galiti D, et al. Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019;27:3949–67.CrossRefPubMed
13.
go back to reference Otto S, Schreyer C, Hafner S, Mast G, Ehrenfeld M, Stürzenbaum S, et al. Bisphosphonate-related osteonecrosis of the jaws - characteristics, risk factors, clinical features, localization and impact on oncological treatment. J Craniomaxillofac Surg. 2012;40:303–9.CrossRefPubMed Otto S, Schreyer C, Hafner S, Mast G, Ehrenfeld M, Stürzenbaum S, et al. Bisphosphonate-related osteonecrosis of the jaws - characteristics, risk factors, clinical features, localization and impact on oncological treatment. J Craniomaxillofac Surg. 2012;40:303–9.CrossRefPubMed
14.
go back to reference Saylor PJ, Rumble RB, Tagawa S, Eastham JA, Finelli A, Reddy PS, et al. Bone Health and Bone-targeted therapies for prostate Cancer: ASCO endorsement of a Cancer Care Ontario Guideline. J Clin Oncol. 2020;38:1736–43.CrossRefPubMed Saylor PJ, Rumble RB, Tagawa S, Eastham JA, Finelli A, Reddy PS, et al. Bone Health and Bone-targeted therapies for prostate Cancer: ASCO endorsement of a Cancer Care Ontario Guideline. J Clin Oncol. 2020;38:1736–43.CrossRefPubMed
15.
go back to reference Shapiro CL, Yarom N, Peterson DE, Bohlke K, Saunders DP. Medication-related osteonecrosis of the jaw: MASCC/ISOO/ASCO clinical practice guideline summary. J Oncol Pract. 2019;15:603–6.CrossRef Shapiro CL, Yarom N, Peterson DE, Bohlke K, Saunders DP. Medication-related osteonecrosis of the jaw: MASCC/ISOO/ASCO clinical practice guideline summary. J Oncol Pract. 2019;15:603–6.CrossRef
16.
go back to reference Sim IW, Sanders KM, Borromeo GL, Seymour JF, Ebeling PR. Declining incidence of medication-related osteonecrosis of the Jaw in patients with Cancer. J Clin Endocrinol Metab. 2015;100:3887–93.CrossRefPubMed Sim IW, Sanders KM, Borromeo GL, Seymour JF, Ebeling PR. Declining incidence of medication-related osteonecrosis of the Jaw in patients with Cancer. J Clin Endocrinol Metab. 2015;100:3887–93.CrossRefPubMed
17.
18.
go back to reference Coleman R, Woodward E, Brown J, Cameron D, Bell R, Dodwell D, et al. Safety of zoledronic acid and incidence of osteonecrosis of the jaw (ONJ) during adjuvant therapy in a randomised phase III trial (AZURE: BIG 01–04) for women with stage II/III breast cancer. Breast Cancer Res Treat. 2011;127:429–38.CrossRefPubMed Coleman R, Woodward E, Brown J, Cameron D, Bell R, Dodwell D, et al. Safety of zoledronic acid and incidence of osteonecrosis of the jaw (ONJ) during adjuvant therapy in a randomised phase III trial (AZURE: BIG 01–04) for women with stage II/III breast cancer. Breast Cancer Res Treat. 2011;127:429–38.CrossRefPubMed
19.
go back to reference Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and maxillofacial surgeons’ position paper on medication-related osteonecrosis of the Jaws-2022 Update. J Oral Maxillofac Surg. 2022;80:920–43.CrossRefPubMed Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and maxillofacial surgeons’ position paper on medication-related osteonecrosis of the Jaws-2022 Update. J Oral Maxillofac Surg. 2022;80:920–43.CrossRefPubMed
20.
go back to reference Limones A, Sáez-Alcaide LM, Díaz-Parreño SA, Helm A, Bornstein MM, Molinero-Mourelle P. Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients treated with denosumab VS. zoledronic acid: a systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2020;25:e326–36.PubMedPubMedCentral Limones A, Sáez-Alcaide LM, Díaz-Parreño SA, Helm A, Bornstein MM, Molinero-Mourelle P. Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients treated with denosumab VS. zoledronic acid: a systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2020;25:e326–36.PubMedPubMedCentral
21.
go back to reference Campisi G, Mauceri R, Bertoldo F, Bettini G, Biasotto M, Colella G, et al. Medication-related osteonecrosis of Jaws (MRONJ) Prevention and diagnosis: Italian Consensus Update 2020. Int J Environ Res Public Health. 2020;17:5998.CrossRefPubMedPubMedCentral Campisi G, Mauceri R, Bertoldo F, Bettini G, Biasotto M, Colella G, et al. Medication-related osteonecrosis of Jaws (MRONJ) Prevention and diagnosis: Italian Consensus Update 2020. Int J Environ Res Public Health. 2020;17:5998.CrossRefPubMedPubMedCentral
22.
go back to reference Nicolatou-Galitis O, Schiødt M, Mendes RA, Ripamonti C, Hope S, Drudge-Coates L, et al. Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019;127:117–35.CrossRefPubMed Nicolatou-Galitis O, Schiødt M, Mendes RA, Ripamonti C, Hope S, Drudge-Coates L, et al. Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019;127:117–35.CrossRefPubMed
23.
go back to reference Bergdahl J, Jarnbring F, Ehrenstein V, Gammelager H, Granath F, Kieler H, et al. Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register. Clin Epidemiol. 2013;5:1–7.CrossRefPubMedPubMedCentral Bergdahl J, Jarnbring F, Ehrenstein V, Gammelager H, Granath F, Kieler H, et al. Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient Register. Clin Epidemiol. 2013;5:1–7.CrossRefPubMedPubMedCentral
Metadata
Title
The trend of dental check-up and prevalence of dental complications following the use of bone modifying agents in patients with metastatic breast and prostate cancer: analysis of data from the Korean National Health Insurance Service
Authors
Ah Reum Lim
Wonse Park
Seok Joo Moon
Min Sun Kim
Soohyeon Lee
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10859-7

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