title: A systematic review of bisphosphonate osteonecrosis (BON) in cancer.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Biologic and Diagnostic Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA. migliorati@uthsc.edu
authors.forename: Cesar Augusto
authors.initials: CA
authors.lastname: Migliorati
authors.forename: Sook-Bin
authors.initials: SB
authors.lastname: Woo
authors.forename: Ian
authors.initials: I
authors.lastname: Hewson
authors.forename: Andrei
authors.initials: A
authors.lastname: Barasch
authors.forename: Linda S
authors.initials: LS
authors.lastname: Elting
authors.forename: Fred K L
authors.initials: FK
authors.lastname: Spijkervet
authors.forename: Michael T
authors.initials: MT
authors.lastname: Brennan
mesh_terms: D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D010020:Osteonecrosis / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D011788:Quality of Life
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
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