Body Jean-Jacques, Coleman Rob, Clezardin Philippe, Ripamonti Carla, Rizzoli Rene, Aapro Matti
Université Libre de Bruxelles, Institut Jules Bordet and CHU Brugmann, Brussels, Belgium.
Eur J Cancer. 2007 Mar;43(5):852-8. doi: 10.1016/j.ejca.2006.12.006. Epub 2007 Jan 26.
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.
老年肿瘤学会（SIOG）的一个特别工作组查阅了截至2005年12月发表在文献（PubMed）中有关双膦酸盐用于老年骨转移患者的信息。还从制造商处获取了其他相关数据。推荐在患有骨转移的老年人中使用双膦酸盐以预防骨相关事件。静脉制剂更适合用于治疗高钙血症。已认识到唑来膦酸、伊班膦酸和帕米膦酸可有效缓解转移性骨痛。应监测每位患者的肌酐清除率，在有证据表明疗效相似的情况下，应使用肾毒性较小的药物。建议评估并优化水化状态。由于存在颌骨坏死的风险，建议在使用双膦酸盐之前由牙科团队进行常规口腔检查并治疗牙齿问题。医生应选择最合适的双膦酸盐。安全预防措施在老年患者中尤为重要。该人群还需要进一步研究。
