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

Jean Jacques Body, Rob Coleman, Philippe Clezardin, Carla Ripamonti, Rene Rizzoli, Matti Aapro

Research output: Contribution to journalArticle


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.

Original languageEnglish
Pages (from-to)852-858
Number of pages7
JournalEuropean Journal of Cancer
Issue number5
Publication statusPublished - Mar 2007



  • Bisphosphonates
  • Bone metastases
  • Bone pain
  • Clinical practice recommendations
  • Elderly
  • Renal safety
  • SIOG

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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