European Journal of Cancer
Volume 43, Issue 5 , Pages 852-858, March 2007

International society of geriatric oncology (SIOG) clinical practice recommendations for the use of bisphosphonates in elderly patients

  • Jean-Jacques Body

      Affiliations

    • Université Libre de Bruxelles, Institut Jules Bordet and CHU Brugmann, Brussels, Belgium
    • Corresponding Author InformationCorresponding author: Tel.: +32 2 541 3303; fax: +32 2 541 3311.
    • ,
  • Rob Coleman

      Affiliations

    • Weston Park Hospital, Sheffield, UK
    • ,
  • Philippe Clezardin

      Affiliations

    • INSERMU.664, Lyon, France
    • ,
  • Carla Ripamonti

      Affiliations

    • Rehabilitation and Palliative Care Unit, National Cancer Institute of Milan, Italy
    • ,
  • Rene Rizzoli

      Affiliations

    • University Hospital, Geneva, Switzerland
    • ,
  • Matti Aapro

      Affiliations

    • Clinique de Genolier, Geneva, Switzerland

Received 18 September 2006; received in revised form 6 December 2006; accepted 8 December 2006.

Abstract 

A society of geriatric oncology (SIOG) task force reviewed information from the literature (in PubMed) on bisphosphonates in elderly patients with bone metastases until December 2005. Additional pertinent data were obtained from the manufacturers.

Bisphosphonates are recommended in the elderly with bone metastases to prevent skeletal-related events. Intravenous formulations are preferred for the treatment of hypercalcaemia. It has been recognised that zoledronic acid, ibandronate and pamidronate can effectively contribute in relieving metastatic bone pain. Creatinine clearance should be monitored in every patient, and a less renally toxic agent should be used where evidence of similar efficacy is available. The assessment and optimisation of hydration status is recommended. Due to the risk from osteonecrosis of the jaw, routine oral examination and treatment of dental problems by a dental team is recommended before bisphosphonates.

Physicians should choose the most appropriate bisphosphonate. Safety precautions are particularly important in elderly patients. Further research is needed in this population.

Keywords: Bisphosphonates, Bone metastases, Bone pain, Clinical practice recommendations, Elderly, SIOG, Renal safety

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PII: S0959-8049(06)01069-0

doi:10.1016/j.ejca.2006.12.006

European Journal of Cancer
Volume 43, Issue 5 , Pages 852-858, March 2007

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