Abstract 1827P
Background
The management of patients on pure anti-angiogenic drugs (Bevacizumab) poses a real problem in odontostomatology in terms of what to do in view of a surgical act in dentistry, given the total absence of a reliable, credible and codified study of the management of these patients at the oral-dental level. The aim of this study is to assess bleeding time in patient under bevacizumab undergoing dental extraction.
Methods
We performed dental extractions in patients on bevacizumab (Beva) plus chemotherapy for their cancer. No interruption of bevacizumab or chemotherapy treatment was performed. The use of haemostatic products was avoided. A control group receiving chemotherapy alone underwent the same procedure. The bleeding time was assessed from tooth avulsion to complete cessation of bleeding after bi-digital compression.
Results
We included 65 patients (39 Chemotherapy + Beva group; 26 Chemotherapy alone group). Men represent 62.2% in the Beva group vs 42.3% in the control group. The mean age is 66.1 years vs 44.6 years respectively. Colon cancer is the most common cancer in the Beva group (63.9%) while nasopharyngeal cancer is in first place in the control group (50%). The mean duration without Beva is 25.5 months. The mean time to stop bleeding in minutes is 6.1 in the Beva group vs 1.4 in the control group (p=.000). Prolonged bleeding (more than 3 minutes) is found in 60% of patients in the Beva group vs 3.8% in the control group (p=.000). The average duration in minutes of the extraction is 16.5 in the Beva group vs 15.3 in the control group. We compared patients with a bleeding time > 3 minutes (prolonged bleeding: group A), to those with a bleeding time < 3 minutes (group B) in the Beva patients: extraction from the maxilla was found in 85.7% of patients (group A) vs 35.7% of patient (group B) (p=.004). The mean Beva exposure (months) is 10 vs 4.3 (p=.051) and the mean Beva dose (mg) is 528.7 vs 370.4 (p=.043) in groups A & B respectively.
Conclusions
Tooth extraction is a possible event during bevacizumab treatment. The current attitude is to stop the anti-angiogenic a few weeks before and after dental surgery, with a risk of disease progression. It appears that non-interruption of treatment is safe, ensuring a good quality of life without disrupting the planned treatment strategy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.