Osteosarcoma Treatment

NewsGuard 100/100 Score

The treatment of osteosarcoma should commence immediately after the diagnosis has been confirmed. Timely management is likely to improve the prognosis of individuals affected by the condition, as the tumor will be removed and treated more efficiently and without allowing it additional time to grow and spread.

Image Credit: April stock/Shutterstock.com

Image Credit: April stock/Shutterstock.com

Treatment typically consists of surgery combined with chemotherapy. The type of surgery depends on the level of progression of the tumor and in some cases, complete amputation of the affected limb is indicated.

It is important for patients with osteosarcoma to receive the appropriate advice and medical management from an orthopedic oncologist who is experienced in the treatment of osteosarcoma.

Neoadjuvant chemotherapy

Currently, the standard treatment is with neoadjuvant chemotherapy, which is later followed by surgical resection and further medical management.

This is essentially chemotherapy administered prior to surgery to physically remove the tumor. The success of the therapy, measured by the percentage of tumor cell necrosis, is an important indicator of the overall prognosis. Additionally, it helps the oncologist to decide upon the chemotherapy regimen to be used after therapy, as it can be altered if the initial combination does not offer a large benefit.

Surgery

The surgery of choice for osteosarcoma involves a complete radical en bloc resection of cancer within the bone. This is also known as limb-salvage orthopedic surgery, as the aim is to maintain the use of the body part and avoid the need for amputation.

In the majority of patients, this provides a successful solution and approximately 9 out of 10 patients are able to salvage the affected limb with this method.

However, occasionally complications can occur that affect the success rate. The complications may include:

  • Infection
  • Prosthetic loosening
  • Tumor recurrence

In the case of complications, there may be a need for further surgery. If it is particularly severe, amputation of the limb may be required to manage the infection or tumor growth.

Pharmacological management

Following surgery, chemotherapy is usually administered in conjunction with a drug called mifamurtide. Research has shown that this combination is able to decrease the mortality rate by 30% in comparison to chemotherapy plus placebo. Six years following treatment, 78% of patients on this medication regime were still alive, with a significant risk reduction.

High-dose methotrexate is usually given as part of the chemotherapy regime in combination with leucovorin rescue, intra-arterial cisplatin, adriamycin, ifosfamide, with mesna, bleomycin, cyclophosphamide, dactinomycin, etoposide or muramyl tripeptide.

As with all chemotherapy, there is a place for antiemetic drugs to help reduce nausea and vomiting. Additionally, fluids are often given to keep patients hydrated. If the blood cell count is low, blood transfusions may be needed, as well as drugs such as filgrastim or pegfilgrastim.

If the necrosis rate is low, indicating poor efficacy of the chemotherapy treatment, ifosfamide can be used as an additional treatment method to improve the success of the therapy.

In some patients, there may be a role for rotationalplasty to allow the patient to be able to conduct movements that may not have been possible without the surgery.

Therapy success

Chemotherapy offers several benefits and is successful for many individuals with osteosarcoma. However, it still has one of the lowest survival rates when compares to other types of pediatric cancer.

The most optimistic 10-year survival rate has been reported as 92%, which involved an aggressive regimen administered intra-arterially with an individualized therapy based of arteriographic response.

Further Reading

Last Updated: Jun 30, 2022

Yolanda Smith

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.

Citations

Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Smith, Yolanda. (2022, June 30). Osteosarcoma Treatment. News-Medical. Retrieved on May 28, 2024 from https://www.news-medical.net/health/Osteosarcoma-Treatment.aspx.

  • MLA

    Smith, Yolanda. "Osteosarcoma Treatment". News-Medical. 28 May 2024. <https://www.news-medical.net/health/Osteosarcoma-Treatment.aspx>.

  • Chicago

    Smith, Yolanda. "Osteosarcoma Treatment". News-Medical. https://www.news-medical.net/health/Osteosarcoma-Treatment.aspx. (accessed May 28, 2024).

  • Harvard

    Smith, Yolanda. 2022. Osteosarcoma Treatment. News-Medical, viewed 28 May 2024, https://www.news-medical.net/health/Osteosarcoma-Treatment.aspx.

Comments

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
Post

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.