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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">surgonco</journal-id><journal-title-group><journal-title xml:lang="ru">Креативная хирургия и онкология</journal-title><trans-title-group xml:lang="en"><trans-title>Creative surgery and oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2076-3093</issn><issn pub-type="epub">2307-0501</issn><publisher><publisher-name>Башкирский государственный медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24060/2076-3093-2022-12-2-151-158</article-id><article-id custom-type="elpub" pub-id-type="custom">surgonco-696</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Профилактика лекарственного остеонекроза челюстей у онкологических пациентов</article-title><trans-title-group xml:lang="en"><trans-title>Prevention Of Drug-Induced Osteonecrosis Of The Jaw In Cancer Patients</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0084-8525</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Спевак</surname><given-names>Е. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Spevak</surname><given-names>E. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., отделение челюстно-лицевой хирургии</p><p>Ставрополь </p></bio><bio xml:lang="en"><p> Cand. Sci. (Med.), Department of Maxillofacial Surgery</p><p> Stavropol </p></bio><email xlink:type="simple">cymbal.elena@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2624-7453</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Христофорандо</surname><given-names>Д. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Christophorando</surname><given-names>D. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p> д.м.н., доцент, кафедра хирургической стоматологии и  челюстно-лицевой хирургии, отделение челюстно-лицевой хирургии</p><p> Ставрополь </p></bio><bio xml:lang="en"><p> Dr. Sci. (Med.), Assoc. Prof., Department of Surgical Dentistry and Maxillofacial Surgery, Department of Maxillofacial Surgery </p><p> Stavropol </p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3118-9139</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шутов</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shutov</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кафедра онкологии и лучевой терапии, отделение торакальнойхирургии</p><p> Ставрополь </p></bio><bio xml:lang="en"><p> Department of Oncology and Radiotherapy, Department of Thoracic Surgery </p><p> Stavropol </p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6484-3520</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ермакова</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Ermakova</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>отделение химиотерапии №4</p><p> Ставрополь </p></bio><bio xml:lang="en"><p> Department of Chemotherapy No. 4 </p><p> Stavropol </p></bio><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Городская клиническая больница скорой медицинской помощи</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Clinical Emergency Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Городская клиническая больница скорой медицинской помощи;&#13;
Ставропольский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Clinical Emergency Hospital;&#13;
Stavropol State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Ставропольский государственный медицинский университет;&#13;
Ставропольский краевой клинический онкологический диспансер</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Stavropol State Medical University;&#13;
Stavropol Regional Clinical Oncology Dispensary</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Ставропольский краевой клинический онкологический диспансер</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Stavropol Regional Clinical Oncology Dispensary,</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>15</day><month>07</month><year>2022</year></pub-date><volume>12</volume><issue>2</issue><fpage>151</fpage><lpage>158</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Спевак Е.М., Христофорандо Д.Ю., Шутов В.А., Ермакова А.В., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Спевак Е.М., Христофорандо Д.Ю., Шутов В.А., Ермакова А.В.</copyright-holder><copyright-holder xml:lang="en">Spevak E.M., Christophorando D.Y., Shutov V.A., Ermakova A.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.surgonco.ru/jour/article/view/696">https://www.surgonco.ru/jour/article/view/696</self-uri><abstract><p>Возникновение лекарственного остеонекроза челюстей у онкологических пациентов, принимающих остеомодифицирующие агенты (бисфосфонаты и деносумаб), является актуальной темой современной медицины. Ее изучением занимаются представители разных специальностей: стоматологи, челюстно-лицевые хирурги, онкологи. Несмотря на большое количество информации, практическая реализация путей профилактики лекарственного остеонекроза челюстей разработана слабо, что подтверждают возрастающая распространенность и утяжеление клинического течения заболевания. В статье проанализированы наиболее заметные публикации и позиционные документы по данной теме в России и в мире за последние 10 лет, а также собственный научно-клинический опыт авторов, определены ключевые проблемы неэффективной профилактики лекарственного остеонекроза челюстей у онкопациентов и предложены пути их решения. Подняты вопросы о необходимости правовой защиты интересов пациентов и клиницистов в отношении данного осложнения. Представлены разработки по лабораторной диагностике и оценке рисков лекарственного остеонекроза челюстей у онкологических пациентов с определением маркеров костного метаболизма. Выделены критерии безопасного использования бисфосфонатов и деносумаба для онкологических пациентов: стоматологический скрининг, клинический и лабораторный контроль, индивидуализация режима дозирования и сроков применения и отмены, междисциплинарный подход.</p></abstract><trans-abstract xml:lang="en"><p>The occurrence of drug-induced osteonecrosis of the jaw in cancer patients treated using bone-modifying medications (bisphosphonates and denosumab) is a highly relevant research problem studied by dentists, maxillofacial surgeons, and oncologists. Despite the large number of publications, practical approaches to preventing drug-induced osteonecrosis of the jaw remain to be developed, which is confirmed by the increasing prevalence and severity of the clinical course of the disease. In this article, we review the most significant works and position papers published in Russia and abroad over the past 10 years, as well as the authors’ scientific and clinical experience, in order to identify key reasons behind the ineffective prevention of drug-induced osteonecrosis of the jaw in cancer patients and to suggests possible solutions. Questions concerning the legal protection of patients and clinicians in relation to this complication are discussed. Most recent achievements in the field of laboratory diagnostics and risk assessment of drug-induced osteonecrosis of the jaw in cancer patients, including the determination of bone metabolism markers, are presented. The following criteria for the safe use of bisphosphonates and denosumab in cancer patients were identified: dental screening; clinical and laboratory monitoring; individualizing drug dosage, duration and withdrawal regimens; application of an interdisciplinary approach.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>бисфосфонатный остеонекроз челюстей</kwd><kwd>бисфосфонаты</kwd><kwd>деносумаб</kwd><kwd>побочные эффекты лекарств</kwd><kwd>маркеры костного метаболизма</kwd><kwd>злокачественная опухоль</kwd><kwd>метастазы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>bisphosphonate osteonecrosis of the jaw</kwd><kwd>bisphosphonates</kwd><kwd>denosumab</kwd><kwd>drug side effects</kwd><kwd>bone metabolism markers</kwd><kwd>malignant tumor</kwd><kwd>metastases</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Шевцова В.В. 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