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A systematic review of bisphosphonate osteonecrosis (BON) in cancer

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Abstract

Purpose

This systematic review aims to examine the prevalence of bisphosphonate osteonecrosis (BON) in the cancer population, prevention and treatment protocols, and quality of life issues.

Methods

A search of MEDLINE/PubMed and EMBASE form October 2003 to December 31, 2008 was conducted with the objective of identifying publications that contained original data regarding BON.

Results

A total of 28 publications fulfilled inclusion criteria, but only 22 were used for prevalence analysis. No randomized controlled clinical trials, meta-analysis, or quality of life papers were found that contained information regarding either prevalence or treatment protocols for the management of BON. The overall weighted prevalence of BON included a sample of 39,124 patients with a mean weighted prevalence of 6.1%. The weighted prevalence was 13.3% for studies with documented follow-up with a sample size of 927 individuals. The weighted prevalence in studies with undocumented follow-up was 0.7% in a sample of 8,829 chart reviews. Epidemiological studies evaluated a total of 29,368 individual records, and the weighted BON prevalence was 1.2%.

Conclusions

High-quality studies are needed to accurately characterize the prevalence of BON, and to determine effective treatment protocols.

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Authors and Affiliations

  1. Department of Biologic and Diagnostic Sciences, College of Dentistry, University of Tennessee Health Science Center, 875 Union Ave suite N228, Memphis, TN, 38163, USA

    Cesar Augusto Migliorati

  2. Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, 1620 Tremont Street, Suite 3-028, Boston, MA, 02120, USA

    Sook-Bin Woo

  3. Royal Melbourne Hospital, Grattan St Parkville, Victoria, 3050, Australia

    Ian Hewson

  4. Dept. of General Dental Sciences, University of Alabama at Birmingham, SDB 111 1530 3rd Avenue S, Birmingham, AL, 35294-0007, USA

    Andrei Barasch

  5. Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Linda S. Elting

  6. Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein1, 9700 RB, Groningen, The Netherlands

    Fred K. L. Spijkervet

  7. Department of Oral Medicine, Carolinas Medical Center, P. O. Box 32861, Charlotte, NC, 28232, USA

    Michael T. Brennan

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  1. Cesar Augusto Migliorati
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  2. Sook-Bin Woo
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  3. Ian Hewson
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  4. Andrei Barasch
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  5. Linda S. Elting
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  6. Fred K. L. Spijkervet
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  7. Michael T. Brennan
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Consortia

Bisphosphonate Osteonecrosis Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO)

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Correspondence to Cesar Augusto Migliorati.

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Migliorati, C.A., Woo, SB., Hewson, I. et al. A systematic review of bisphosphonate osteonecrosis (BON) in cancer. Support Care Cancer 18, 1099–1106 (2010). https://doi.org/10.1007/s00520-010-0882-1

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  • DOI: https://doi.org/10.1007/s00520-010-0882-1

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