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Teriparatide therapy for severe, refractory osteoradionecrosis of the jaw

Authors
 Y H Cha  ;  N Hong  ;  Y Rhee  ;  I-H Cha 
Citation
 Osteoporosis International, Vol.29(4) : 987-992, 2018 
Journal Title
 Osteoporosis International 
ISSN
 0937-941X 
Issue Date
2018
Keywords
Osteoradionecrosis ; Radiation therapy ; Recombinant human parathyroid hormone (1-34)
Abstract
Although osteoradionecrosis (ORN) is a serious complication of craniofacial radiotherapy, the current management methods remain suboptimal. Teriparatide (TPTD), a recombinant human parathyroid hormone (1-34), has shown beneficial effects on osseous regeneration in medication-related osteonecrosis of the jaw or periodontitis. However, TPTD therapy in irradiated bones has not been indicated yet because of the theoretical risk of osteosarcoma seen in rat models. Hence, we first report here two patients with tongue cancer with late-emerging ORN who were successfully treated with TPTD for 4-6 months with serum calcium and vitamin D supplementation. In contrast to the usual progress of ORN, the bone defect regenerated well and bone turnover markers including serum C-terminal telopeptide of type 1 collagen and osteocalcin were restored with TPTD therapy. Our experience might suggest that TPTD therapy with careful monitoring can provide an effective treatment option for patients with ORN in select refractory cases, with the benefits outweighing the potential risks.
Full Text
https://link.springer.com/article/10.1007%2Fs00198-017-4343-2
DOI
10.1007/s00198-017-4343-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Cha, Yong Hoon(차용훈) ORCID logo https://orcid.org/0000-0003-1761-3260
Cha, In Ho(차인호) ORCID logo https://orcid.org/0000-0001-8259-2190
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162539
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