Potential significance of antiestrogen therapy in the development of bisphosphonate related osteonecrosis of the jaw.

OBJECTIVES: There are known risk factors and established treatment protocols for bisphosphonate-related osteonecrosis of the jaw (BRONJ), but it remains a difficult disease to treat, with the risk of relapses. This study investigates whether or not there is a relationship between antiestrogen therapy and BRONJ. PATIENTS AND METHODS: In our prospective study, we followed up 93 patients with BRONJ who were seen at our clinic between 2006 and 2011. RESULTS: We found that breast cancer patients had a significantly worse prognosis than patients with other underlying illnesses (p < 0.01), which might indicate the role of antiestrogen therapy (p < 0.001) as a causative factor. CONCLUSION: The dominance of the female gender among BRONJ patients as well as our new findings related to antiestrogen therapy of breast cancer raise the possibility that estrogen deficiency might be a newly discovered risk factor for BRONJ.

[Survival prospects of mesopharyngeal carcinoma patients treated primarily with intraarterial chemotherapy. A retrospective study]. / Elsodlegesen intraarteriális kemoterápiával kezelt mesopharynx-carcinomás betegek túlélési kilátásai. Retrospektív vizsgálat.

BACKGROUND: The radical removal of mesopharyngeal tumors necessitates very extensive, aggressive surgery. In certain cases, therefore, they strive to ensure the quality of life of these patients by means of two other possibilities in the complex treatment: chemotherapy and irradiation; in this way, over radicality can be avoided. AIM: One of the elements of the complex therapy may be intraarterial chemotherapy. The present work relates to a study of the effects and side-effects of primary intraarterial chemotherapy administrated in the period 1995-2000, and the overall survival of the patients. PATIENTS AND METHOD: Remission was attained in a total of 30 patients who participated in primary intraarterial chemotherapy. The degree of severity of any complications that occurred was studied, as was the duration of survival. Treatment was performed by retrograde cannulation of the external carotid artery and the administration of a relatively low dose of drug for a relatively long time (5-14 days). The intra-arterial chemotherapy was supplemented with other modes of treatment. RESULTS: A clinically observable degree of tumor regression was detected in 83.3% of the cases after the intraarterial treatment. The 5-year survival rate was approximately 30%. CONCLUSIONS: The overall survival rate for oropharyngeal carcinoma patients treated with combined procedures is reported to range between 32% and 83%. Since our patients (with 2 exceptions) were in stage III or IV, and in many cases were inoperable, our 5-year survival rate of approximately 30% may be stated to be acceptable, while the quality of life of the patients was much more favourable than following the primary radical operation.