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127:Pentoxifylline For The Treatment of Medication Related Osteonecrosis Of The Jaw[AAOM2021]
EP36071
Poster Title: 127:Pentoxifylline For The Treatment of Medication Related Osteonecrosis Of The Jaw[AAOM2021]
Submitted on 29 Mar 2021
Author(s): Dennis Shem, Annu Singh, Andrew Pischek, Sae Hee Yom
Affiliations: Memorial Sloan Kettering Cancer Center, United States of America
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 275
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Poster Information
Abstract: Objectives: Medication related osteonecrosis of the jaw (MRONJ) is a well-documented complication of antiresorptive therapy (ART). The primary modality of treatment is conservative management with surgery reserved for severe cases. Pentoxifylline and Tocopherol (PENTO) has been shown in the osteoradionecrosis literature to improve bony healing and resolution of disease. We have reported in the past a subset of 7 patients who showed improvement of their MRONJ symptoms while on PENTO. Since then, there still remains little information available about when to prescribe PENTO and for how long. With this study we seek to update our experience managing patients using PENTO.

Methods: Following approval by the Institutional Review Board at MSKCC, a retrospective review was completed to identify patients diagnosed with MRONJ by the Dental Service at MSKCC and were prescribed PENTO as part of their management. Of the 393 patients eligible, 22 patients were identified fitting the criteria. These patients were diagnosed with MRONJ between 2010 and 2020. All patients received conservative management of their MRONJ. Data is being collected on staging, disease status, number of doses of antiresorptive medications, length of time on PENTO, and panoramic radiographic findings.

Results: On preliminary analysis, 2 patients were already on PENTO prior to evaluation by the dental service. The median time to starting PENTO for the remaining patients was 5 months. Patients were on PENTO for a median of 11 months and average of 18 months (range: 0-105). 63.6% (14/22) of patients were diagnosed with stage 2 MRONJ according to American Academy of Oral and Maxillofacial Surgery guidelines. 50% (11/22) of patients had resolution of their MRONJ as defined by presence of complete mucosal closure without symptoms. The remaining patients had progressive or stable disease identified clinically and radiographically, but all were free of pain.

Conclusions: Further analysis will be conducted in order to determine how exposure to PENTO improved outcomes in MRONJ. We believe information about usage of PENTO as well as clinical and radiographic outcomes will help direct guidelines on when and for how long to initiate therapy as part of care for patients with MRONJ.

Summary: We have reported in the past a subset of 7 patients who showed improvement of their MRONJ symptoms while on PENTO. Since then, there still remains little information available about when to prescribe PENTO and for how long. With this study we seek to update our experience managing patients using PENTO.

Ask the author questions about this poster:drdshem@gmail.com
References: • Owosho AA, Estilo CL, Huryn JM, Yom SK. Pentoxifylline and tocopherol in the management of cancer patients with medication-related osteonecrosis of the jaw: An observational retrospective study of initial case series. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2016.
• Yarom N, Shapiro CL, Peterson DE, et al. Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline. Journal of Clinical Oncology. 2019.
• Patel S, Patel N, Sassoon I, Patel V. The use of pentoxifylline, tocopherol and clodronate in the management of osteoradionecrosis of the jaws.
Radiotherapy and Oncology. 2020.
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