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Medical Forum / Diseases and Disorders / Cancer / January 2006Question for "J" re osteonecrosis
Hi "J", Nana here. I have a question for you, if you don't mind. Yesterday I saw my onc, and he believes the Zometa infusions have caused me to develop osteonecrosis of the jaw. He did a bunch of X-rays, and has ordered more CT scans to look into it further. Now I really wish I had never taken the Zometa, but that's history now. Anyway, do you know of any newsgroups regarding osteonecrosis? I'd like to find out a bit more information. Nana > Hi "J", Nana here. I have a question for you, if you don't mind. Yesterday I > saw my onc, and he believes the Zometa infusions have caused me to develop > osteonecrosis of the jaw. He did a bunch of X-rays, and has ordered more CT > scans to look into it further. Now I really wish I had never taken the > Zometa, but that's history now. Anyway, do you know of any newsgroups > regarding osteonecrosis? I'd like to find out a bit more information. Hi Nana, No, I don't know of a specific newsgroup for that. I've seen posts (perhaps "news items") on various newsgroups (arthritis, dentistry, osteoporosis and chronic pain newsgroups), but not necessarily always specific to the jaw. I've even posted "informational posts" which included that word (when searching the archives). Those newsgroups seem to make sense (to me) because I think it's associated with thinning of the bone, with long term (high dose?) steroid use There was a nice chap who posted here a few years ago, who said he had it in his clavicle and was blaming his radiation treatment at a VA hospital 2 years earlier. It must be rare?, because I don't even see a mail list at ACOR under "O" or "J" (for jaw), but I realize that not everyone has computer access. There's a webpage here http://www.nonf.org/ (I haven't had a chance to throughly check them out). and it's mention on the BC can website http://www.bccancer.bc.ca/HPI/DrugDatabase/DrugIndexPro/Pamidronate.htm and there's a name of doctor here, if that's what you have http://www.bccancer.bc.ca/HPI/AnnualConference/Sessions/oraloncology.htm Sending good vibes that's not what you have. ( ( ( Nana ) ) ) Hang in there and let us know, please, J >> Hi "J", Nana here. I have a question for you, if you don't mind. >> Yesterday I [quoted text clipped - 36 lines] > ( ( ( Nana ) ) ) Hang in there and let us know, please, > J OK, thanks. I'll check out those links. I did a google search on "Femara Jaw Osteonecrosis" and it comes up with a fair bit, but not anything on treatment, etc. I do have very good dental hygene so that is not a contributor, but I had a tooth extraction late summer, and I guess that was my downfall. No one told me not to have a tooth extraction when being treated with bisphosphonates. Unfortunately the onc is pretty sure that I have it, but I really hope he is wrong. On the 16th I have some CT scans coming up, and I had the xrays done already so I should know more soon. Thanks for the good vibes, my radar is out catching as much of them as I can :) Nana Br J Radiol. 2002 May; 75(893): 467-9. Related Articles, Links Complete healing of severe osteoradionecrosis with treatment combining pentoxifylline, tocopherol and clodronate. Delanian S, Lefaix JL. Service d'Oncologie-Radiotherapie, Hopital Saint-Louis APHP, 1 Ave Claude Vellefaux, 75010 Paris, France. Osteoradionecrosis (ORN) is a late terminal sequela of irradiation that does not resolve spontaneously. In a preliminary study, a combination of pentoxifylline (PTX), tocopherol (Vit-E) and clodonate has been shown to be of clinical benefit with more than 50% regression of progressive ORN observed at 6 months in 12 patients. A 68-year-old woman presenting with severe exteriorized osteoradionecrosis had received radiotherapy for breast cancer 29 years previously. She had palpable breast fibrosis, including the sternum (15 cm x 11 cm) and a painful fistulous track in the upper part of the bone (orifice diameter 10 mm) surrounded by local inflammatory signs, and chronic osteitis with sequestra extrusion. MRI showed deep radiation-induced fibrosis below this area without cancer recurrence, and complete bone destruction over an area of 7 cm x 4 cm. Oral PTX (800 mg day(-1)), Vit.E (1000 IU day(-1)) and clodronate (1600 mg day(-1)) were administered daily for 3 years and were well tolerated. The patient exhibited regular clinical improvement until complete closure of the fistula and total regression of the clinical fibrosis. MRI confirmed the good response and showed heterogeneous restoration of the sternum, which was filled with new tissue. This is the first time that antifibrotic treatment with combined PTX-Vit.E plus clodronate has been shown to have a significant effect on necrosis, by completely reversing severe progressive ORN and the associated radiation-induced fibrosis. Publication Types: Case Reports PMID: 12036843 [PubMed - indexed for MEDLINE] ------------------------------------------------------------------------------ -- <<snip>> PTX-vitamin E boosted by clodronate is an effective treatment that induces mucosal and bone healing in a median period of 6 months <<snip>> Head Neck. 2005 Jan 7; [Epub ahead of print] Related Articles, Links Major healing of refractory mandible osteoradionecrosis after treatment combining pentoxifylline and tocopherol: A phase II trial. Delanian S, Depondt J, Lefaix JL. Service Oncologie-Radiotherapie, 1, ave Claude Vellefaux, 75010 Paris, France. BACKGROUND.: Osteoradionecrosis (ORN) is a nonhealing wound of the bone that is difficult to manage. Is a treatment combining pentoxifylline (PTX) and tocopherol (vitamin E) boosted by clodronate effective in reversing this fibronecrotic process? METHODS.: Eighteen consecutive patients previously irradiated for head and neck cancer had exteriorized mandible ORN. Length of exposed bone (L) was 13.4 +/- 8 mm, and the mean subjective objective medical management and analytic evaluation of injury (SOMA) score was 12.6 +/- 4.9. Between June 1995 and January 2002, all 18 were given a daily oral combination of 800 mg of PTX and 1000 IU of vitamin E for 6 to 24 months. In addition, the last eight patients who were the worst cases were given 1600 mg/day clodronate 5 days a week. RESULTS.: The treatment was well tolerated. All patients improved at 6 months, with 84% mean L and 67% mean SOMA score reductions. Sixteen (89%) of 18 patients achieved complete recovery, 14 in 5 +/- 2.6 months. The remaining two patients exhibited a 75% response at 6 months. CONCLUSION.: PTX-vitamin E boosted by clodronate is an effective treatment of mandibular ORN that induces mucosal and bone healing in a median period of 6 months. (c) 2005 Wiley Periodicals, Inc. Head Neck 27: XXX-XXX, 2005. PMID: 15641107 [PubMed - as supplied by publisher] ---------------------------------------------------------------------------- >>snip<< In these reactions iron plays an important role suggesting that the selective in vitro antioxidant properties of the bisphosphonates are due to their iron chelating characteristics. >>snip<< Biochem Biophys Res Commun. 2004 Feb 13; 314(3): 675-80. Related Articles, Links Selective in vitro antioxidant properties of bisphosphonates. Dombrecht EJ, Cos P, Berghe DV, Offel JF, Schuerwegh AJ, Bridts CH, Stevens WJ, De Clerck LS. Laboratory of Immunology, Allergology and Rheumatology, Department of Medicine, University of Antwerp, Universiteitsplein 1, B-2610, Antwerp, Belgium The aim of this study was to investigate the in vitro antioxidant profile of different bisphosphonates. Bisphosphonates were tested for their xanthine oxidase and microsomal lipid peroxidation inhibiting capacity. Furthermore, the effect of these different compounds on DPPH, a stable radical, was investigated. Clodronate, risedronate, and pyrophosphate were further tested for their hydroxyl radical scavenging activity. None of the tested compounds showed xanthine oxidase inhibiting activity or DPPH scavenging activity. All the tested bisphosphonates exhibited inhibiting capacities on the microsomal lipid peroxidation. The hydroxyl radical scavenging activity was dependent on the order of adding the different reagents and was highest for risedronate. Bisphosphonates possess an inhibiting activity on the microsomal lipid peroxidation and the Fenton reaction. In these reactions iron plays an important role suggesting that the selective in vitro antioxidant properties of the bisphosphonates are due to their iron chelating characteristics. PMID: 14741688 [PubMed - in process] ------------------------------------------------------------------------------ -- Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore DEAD PEOPLE WALKING http://pages.ivillage.com/ironjustice/deadpeoplewalking >>Anyway, do you know of any newsgroups regarding osteonecrosis? I'd like to find out a bit more information.<< Osteoradionecrosis .. http://tinyurl.com/cbtr4 Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore DEAD PEOPLE WALKING http://pages.ivillage.com/ironjustice/deadpeoplewalking Br J Radiol. 2002 May; 75(893): 467-9. Related Articles, Links Complete healing of severe osteoradionecrosis with treatment combining pentoxifylline, tocopherol and clodronate. Delanian S, Lefaix JL. Service d'Oncologie-Radiotherapie, Hopital Saint-Louis APHP, 1 Ave Claude Vellefaux, 75010 Paris, France. Osteoradionecrosis (ORN) is a late terminal sequela of irradiation that does not resolve spontaneously. In a preliminary study, a combination of pentoxifylline (PTX), tocopherol (Vit-E) and clodonate has been shown to be of clinical benefit with more than 50% regression of progressive ORN observed at 6 months in 12 patients. A 68-year-old woman presenting with severe exteriorized osteoradionecrosis had received radiotherapy for breast cancer 29 years previously. She had palpable breast fibrosis, including the sternum (15 cm x 11 cm) and a painful fistulous track in the upper part of the bone (orifice diameter 10 mm) surrounded by local inflammatory signs, and chronic osteitis with sequestra extrusion. MRI showed deep radiation-induced fibrosis below this area without cancer recurrence, and complete bone destruction over an area of 7 cm x 4 cm. Oral PTX (800 mg day(-1)), Vit.E (1000 IU day(-1)) and clodronate (1600 mg day(-1)) were administered daily for 3 years and were well tolerated. The patient exhibited regular clinical improvement until complete closure of the fistula and total regression of the clinical fibrosis. MRI confirmed the good response and showed heterogeneous restoration of the sternum, which was filled with new tissue. This is the first time that antifibrotic treatment with combined PTX-Vit.E plus clodronate has been shown to have a significant effect on necrosis, by completely reversing severe progressive ORN and the associated radiation-induced fibrosis. Publication Types: Case Reports PMID: 12036843 [PubMed - indexed for MEDLINE] ------------------------------------------------------------------------ ---?--- -- <> PTX-vitamin E boosted by clodronate is an effective treatment that induces mucosal and bone healing in a median period of 6 months <> Head Neck. 2005 Jan 7; [Epub ahead of print] Related Articles, Links Major healing of refractory mandible osteoradionecrosis after treatment combining pentoxifylline and tocopherol: A phase II trial. Delanian S, Depondt J, Lefaix JL. Service Oncologie-Radiotherapie, 1, ave Claude Vellefaux, 75010 Paris, France. BACKGROUND.: Osteoradionecrosis (ORN) is a nonhealing wound of the bone that is difficult to manage. Is a treatment combining pentoxifylline (PTX) and tocopherol (vitamin E) boosted by clodronate effective in reversing this fibronecrotic process? METHODS.: Eighteen consecutive patients previously irradiated for head and neck cancer had exteriorized mandible ORN. Length of exposed bone (L) was 13.4 +/- 8 mm, and the mean subjective objective medical management and analytic evaluation of injury (SOMA) score was 12.6 +/- 4.9. Between June 1995 and January 2002, all 18 were given a daily oral combination of 800 mg of PTX and 1000 IU of vitamin E for 6 to 24 months. In addition, the last eight patients who were the worst cases were given 1600 mg/day clodronate 5 days a week. RESULTS.: The treatment was well tolerated. All patients improved at 6 months, with 84% mean L and 67% mean SOMA score reductions. Sixteen (89%) of 18 patients achieved complete recovery, 14 in 5 +/- 2.6 months. The remaining two patients exhibited a 75% response at 6 months. CONCLUSION.: PTX-vitamin E boosted by clodronate is an effective treatment of mandibular ORN that induces mucosal and bone healing in a median period of 6 months. (c) 2005 Wiley Periodicals, Inc. Head Neck 27: XXX-XXX, 2005. PMID: 15641107 [PubMed - as supplied by publisher] ------------------------------------------------------------------------ ---?- >>snip<< In these reactions iron plays an important role suggesting that the selective in vitro antioxidant properties of the bisphosphonates are due to their iron chelating characteristics. >>snip<< Biochem Biophys Res Commun. 2004 Feb 13; 314(3): 675-80. Related Articles, Links Selective in vitro antioxidant properties of bisphosphonates. Dombrecht EJ, Cos P, Berghe DV, Offel JF, Schuerwegh AJ, Bridts CH, Stevens WJ, De Clerck LS. Laboratory of Immunology, Allergology and Rheumatology, Department of Medicine, University of Antwerp, Universiteitsplein 1, B-2610, Antwerp, Belgium The aim of this study was to investigate the in vitro antioxidant profile of different bisphosphonates. Bisphosphonates were tested for their xanthine oxidase and microsomal lipid peroxidation inhibiting capacity. Furthermore, the effect of these different compounds on DPPH, a stable radical, was investigated. Clodronate, risedronate, and pyrophosphate were further tested for their hydroxyl radical scavenging activity. None of the tested compounds showed xanthine oxidase inhibiting activity or DPPH scavenging activity. All the tested bisphosphonates exhibited inhibiting capacities on the microsomal lipid peroxidation. The hydroxyl radical scavenging activity was dependent on the order of adding the different reagents and was highest for risedronate. Bisphosphonates possess an inhibiting activity on the microsomal lipid peroxidation and the Fenton reaction. In these reactions iron plays an important role suggesting that the selective in vitro antioxidant properties of the bisphosphonates are due to their iron chelating characteristics. PMID: 14741688 [PubMed - in process] ------------------------------------------------------------------------ ---?--- -- Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore DEAD PEOPLE WALKING http://pages.ivillage.com/ironjustice/deadpeoplewalking >>I'd like to find out a bit more information.<< Osteoradionecrosis .. http://tinyurl.com/9w58t Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore DEAD PEOPLE WALKING http://pages.ivillage.com/ironjustice/deadpeoplewalking Br J Radiol. 2002 May; 75(893): 467-9. Related Articles, Links Complete healing of severe osteoradionecrosis with treatment combining pentoxifylline, tocopherol and clodronate. Delanian S, Lefaix JL. Service d'Oncologie-Radiotherapie, Hopital Saint-Louis APHP, 1 Ave Claude Vellefaux, 75010 Paris, France. Osteoradionecrosis (ORN) is a late terminal sequela of irradiation that does not resolve spontaneously. In a preliminary study, a combination of pentoxifylline (PTX), tocopherol (Vit-E) and clodonate has been shown to be of clinical benefit with more than 50% regression of progressive ORN observed at 6 months in 12 patients. A 68-year-old woman presenting with severe exteriorized osteoradionecrosis had received radiotherapy for breast cancer 29 years previously. She had palpable breast fibrosis, including the sternum (15 cm x 11 cm) and a painful fistulous track in the upper part of the bone (orifice diameter 10 mm) surrounded by local inflammatory signs, and chronic osteitis with sequestra extrusion. MRI showed deep radiation-induced fibrosis below this area without cancer recurrence, and complete bone destruction over an area of 7 cm x 4 cm. Oral PTX (800 mg day(-1)), Vit.E (1000 IU day(-1)) and clodronate (1600 mg day(-1)) were administered daily for 3 years and were well tolerated. The patient exhibited regular clinical improvement until complete closure of the fistula and total regression of the clinical fibrosis. MRI confirmed the good response and showed heterogeneous restoration of the sternum, which was filled with new tissue. This is the first time that antifibrotic treatment with combined PTX-Vit.E plus clodronate has been shown to have a significant effect on necrosis, by completely reversing severe progressive ORN and the associated radiation-induced fibrosis. Publication Types: Case Reports PMID: 12036843 [PubMed - indexed for MEDLINE] ------------------------------------------------------------------------------ -- <> PTX-vitamin E boosted by clodronate is an effective treatment that induces mucosal and bone healing in a median period of 6 months <> Head Neck. 2005 Jan 7; [Epub ahead of print] Related Articles, Links Major healing of refractory mandible osteoradionecrosis after treatment combining pentoxifylline and tocopherol: A phase II trial. Delanian S, Depondt J, Lefaix JL. Service Oncologie-Radiotherapie, 1, ave Claude Vellefaux, 75010 Paris, France. BACKGROUND.: Osteoradionecrosis (ORN) is a nonhealing wound of the bone that is difficult to manage. Is a treatment combining pentoxifylline (PTX) and tocopherol (vitamin E) boosted by clodronate effective in reversing this fibronecrotic process? METHODS.: Eighteen consecutive patients previously irradiated for head and neck cancer had exteriorized mandible ORN. Length of exposed bone (L) was 13.4 +/- 8 mm, and the mean subjective objective medical management and analytic evaluation of injury (SOMA) score was 12.6 +/- 4.9. Between June 1995 and January 2002, all 18 were given a daily oral combination of 800 mg of PTX and 1000 IU of vitamin E for 6 to 24 months. In addition, the last eight patients who were the worst cases were given 1600 mg/day clodronate 5 days a week. RESULTS.: The treatment was well tolerated. All patients improved at 6 months, with 84% mean L and 67% mean SOMA score reductions. Sixteen (89%) of 18 patients achieved complete recovery, 14 in 5 +/- 2.6 months. The remaining two patients exhibited a 75% response at 6 months. CONCLUSION.: PTX-vitamin E boosted by clodronate is an effective treatment of mandibular ORN that induces mucosal and bone healing in a median period of 6 months. (c) 2005 Wiley Periodicals, Inc. Head Neck 27: XXX-XXX, 2005. PMID: 15641107 [PubMed - as supplied by publisher] ---------------------------------------------------------------------------- >>snip<< In these reactions iron plays an important role suggesting that the selective in vitro antioxidant properties of the bisphosphonates are due to their iron chelating characteristics. >>snip<< Biochem Biophys Res Commun. 2004 Feb 13; 314(3): 675-80. Related Articles, Links Selective in vitro antioxidant properties of bisphosphonates. Dombrecht EJ, Cos P, Berghe DV, Offel JF, Schuerwegh AJ, Bridts CH, Stevens WJ, De Clerck LS. Laboratory of Immunology, Allergology and Rheumatology, Department of Medicine, University of Antwerp, Universiteitsplein 1, B-2610, Antwerp, Belgium The aim of this study was to investigate the in vitro antioxidant profile of different bisphosphonates. Bisphosphonates were tested for their xanthine oxidase and microsomal lipid peroxidation inhibiting capacity. Furthermore, the effect of these different compounds on DPPH, a stable radical, was investigated. Clodronate, risedronate, and pyrophosphate were further tested for their hydroxyl radical scavenging activity. None of the tested compounds showed xanthine oxidase inhibiting activity or DPPH scavenging activity. All the tested bisphosphonates exhibited inhibiting capacities on the microsomal lipid peroxidation. The hydroxyl radical scavenging activity was dependent on the order of adding the different reagents and was highest for risedronate. Bisphosphonates possess an inhibiting activity on the microsomal lipid peroxidation and the Fenton reaction. In these reactions iron plays an important role suggesting that the selective in vitro antioxidant properties of the bisphosphonates are due to their iron chelating characteristics. PMID: 14741688 [PubMed - in process] ------------------------------------------------------------------------------ -- Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore DEAD PEOPLE WALKING http://pages.ivillage.com/ironjustice/deadpeoplewalking |
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