Response to Denosumab Treatment for 2 Years in an Adolescent With Osteoradionecrosis

J Bone Miner Res. 2015 Oct;30(10):1790-6. doi: 10.1002/jbmr.2519. Epub 2015 May 21.

Abstract

Radiotherapy, an essential component of cancer treatment, is not without risk to bone, particularly to the immature or growing skeleton. Known side effects range from post-radiation osteitis to osteoradionecrosis. We report the case of a 14-year-old male patient undergoing denosumab treatment, a new antiresorptive agent, for osteoradionecrosis. The patient exhibited fractures and associated pain and functional limitations secondary to radiation for the treatment of an embryonal rhabdomyosarcoma of prostate grade III administered at age 5 years. After treatment with denosumab, the pain disappeared, bone remodeling markers dramatically declined, bone mass increased, and pathological bone scan findings resolved without adverse effects or new fractures.

Keywords: ADOLESCENT; BONE MINERAL DENSITY; DENOSUMAB; OSTEORADIONECROSIS; PATHOLOGICAL FRACTURES.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Bone Remodeling / drug effects
  • Denosumab / administration & dosage*
  • Fractures, Bone / blood
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / drug therapy*
  • Fractures, Bone / etiology
  • Humans
  • Male
  • Osteoradionecrosis / blood
  • Osteoradionecrosis / diagnostic imaging
  • Osteoradionecrosis / drug therapy*
  • Osteoradionecrosis / etiology
  • Radiography
  • Radiotherapy / adverse effects
  • Rhabdomyosarcoma, Embryonal / diagnostic imaging
  • Rhabdomyosarcoma, Embryonal / radiotherapy

Substances

  • Biomarkers
  • Denosumab