Osteosarcoma medical therapy: Difference between revisions

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{{CMG}}; {{AE}}[[User:DrMars|Mohammadmain Rezazadehsaatlou[2]]].
{{Osteosarcoma}}
{{Osteosarcoma}}
==Overview==
The predominant therapy for osteosarcoma is [[neoadjuvant]] [[chemotherapy]] ([[chemotherapy]] given before surgey) followed by surgical resection. The most common drugs used to treat osteosarcoma are [[cisplatin]], [[doxorubicin]] and high-dose [[methotrexate]]. [[Ifosfamide]] can be used as an adjuvant treatment if the [[necrosis]] rate is low. [[Samarium]] is a radioactive drug that targets areas where bone cells growing, such as tumor cells in the bone. It relieves bone pain.
==Medical Therapy==
The [[osteosarcoma]] treatment should be determined According to:<ref name="pmid26626558">{{cite journal |vauthors=Bishop MW, Janeway KA, Gorlick R |title=Future directions in the treatment of osteosarcoma |journal=Curr. Opin. Pediatr. |volume=28 |issue=1 |pages=26–33 |date=February 2016 |pmid=26626558 |pmc=4761449 |doi=10.1097/MOP.0000000000000298 |url=}}</ref><ref name="pmid25422073">{{cite journal |vauthors=Szewczyk M, Lechowski R, Zabielska K |title=What do we know about canine osteosarcoma treatment? Review |journal=Vet. Res. Commun. |volume=39 |issue=1 |pages=61–7 |date=March 2015 |pmid=25422073 |pmc=4330401 |doi=10.1007/s11259-014-9623-0 |url=}}</ref><ref name="pmid29182106">{{cite journal |vauthors=Biazzo A, De Paolis M |title=Multidisciplinary approach to osteosarcoma |journal=Acta Orthop Belg |volume=82 |issue=4 |pages=690–698 |date=December 2016 |pmid=29182106 |doi= |url=}}</ref><ref name="pmid29182106" /><ref name="pmid27587886">{{cite journal |vauthors=Selmic LE, Griffin LR, Rector MH, Lafferty M, Pool R, Ehrhart NP |title=Treatment of extraskeletal osteosarcoma at a previous injection site resulting in prolonged survival in 1 dog |journal=Can. Vet. J. |volume=57 |issue=9 |pages=950–4 |date=September 2016 |pmid=27587886 |pmc=4982565 |doi= |url=}}</ref><ref name="pmid29181871">{{cite journal |vauthors=Swift KE, LaRue SM |title=Outcome of 9 dogs treated with stereotactic radiation therapy for primary or metastatic vertebral osteosarcoma |journal=Vet Comp Oncol |volume=16 |issue=1 |pages=E152–E158 |date=March 2018 |pmid=29181871 |doi=10.1111/vco.12362 |url=}}</ref><ref name="pmid23907290">{{cite journal |vauthors=Redondo A, Cruz J, Lopez-Pousa A, Barón F |title=SEOM clinical guidelines for the treatment of osteosarcoma in adults-2013 |journal=Clin Transl Oncol |volume=15 |issue=12 |pages=1037–43 |date=December 2013 |pmid=23907290 |doi=10.1007/s12094-013-1087-0 |url=}}</ref><ref name="pmid22983152">{{cite journal |vauthors=Gill J, Ahluwalia MK, Geller D, Gorlick R |title=New targets and approaches in osteosarcoma |journal=Pharmacol. Ther. |volume=137 |issue=1 |pages=89–99 |date=January 2013 |pmid=22983152 |doi=10.1016/j.pharmthera.2012.09.003 |url=}}</ref><ref name="pmid25993235">{{cite journal |vauthors=Meyers PA |title=Systemic therapy for osteosarcoma and Ewing sarcoma |journal=Am Soc Clin Oncol Educ Book |volume= |issue= |pages=e644–7 |date=2015 |pmid=25993235 |doi=10.14694/EdBook_AM.2015.35.e644 |url=}}</ref>


==Overview==
* Patients age
* Patients overall health
* Patients [[medical history]]
* The [[osteosarcoma]] type
* The [[osteosarcoma]] stage (extent)
* The [[osteosarcoma]] location
* The [[osteosarcoma]] type
* Patients tolerance to specific medicines, procedures or therapies
 
Accordingly, up to this time the available treatment for [[osteosarcoma]] is one of a combination of the following treatments:
*[[Surgery]]
* Prosthetic fitting and training
*[[Radiation therapy]]
*[[Chemotherapy]]
*[[Antibiotic]] therapy to prevent and treat infections
*[[Rehabilitation (neuropsychology)|Rehabilitation]]
* Supportive care for the side effects of therapy
* Continued follow-up care


Family [[physicians]] and orthopedists rarely see a [[malignant]] bone tumor (most bone tumors are [[benign]]). Thus, many patients are initially misdiagnosed with [[cysts]] or muscle problems, and some are sent straight to [[physical therapy]] without an [[x-ray]].
However, the current standard treatment for [[osteosarcoma]] is to use [[neoadjuvant]] [[chemotherapy]] ([[chemotherapy]] given before [[surgery]]) followed by surgical resection.
*The percentage of tumor cell [[necrosis]] (cell death) seen in the tumor after surgery gives an idea of the [[prognosis]] and also lets the oncologist know if the [[chemotherapy]] regimen should be altered after surgery.
*Standard therapy is a combination of limb-salvage [[orthopedic surgery]] and a combination of high dose [[methotrexate]] with [[leucovorin]] rescue, intra-arterial [[cisplatin]], [[caffeine]], [[adriamycin]], [[ifosfamide]] with [[mesna]], BCD, [[etoposide]], and [[Muramyl dipeptide|muramyl]] tripeptide (MTP).
*Fluids are given for hydration. 
*Drugs like [[granisetron]] and [[ondansetron]] help with [[nausea]] and [[vomiting]].
*[[Filgrastim]], [[epoetin alfa]], [[granulocyte colony stimulating factor]] help with [[white blood cell]] counts and [[neutrophil]] counts.
*Blood helps with [[anemia]].


The route to [[osteosarcoma]] diagnosis usually begins with an [[x-ray]], continues with a combination of scans ([[CT scan]], [[PET scan]], bone scan, [[MRI]]) and ends with a surgical [[biopsy]]. Much can be seen on films, but the [[biopsy]] is the only definitive proof that a bone tumor is indeed [[malignant]] or [[benign]].
===Chemotherapy regimens===
*The most common [[chemotherapy]] combinations used to treat [[osteosarcoma]] are:
**[[Cisplatin]], [[doxorubicin]] and high-dose [[methotrexate]].
**[[Cisplatin]] and [[doxorubicin]].


The biopsy of suspected [[osteosarcoma]] should be performed by a qualified orthopedic [[oncologist]]. The [[American Cancer Society]] states: "Probably in no other [[cancer]] is it as important to perform this procedure properly. An improperly performed [[biopsy]] may make it difficult to save the affected limb from [[amputation]]."
*[[Ifosfamide]] can be used as an adjuvant treatment if the [[necrosis]] rate is low.
===Samarium===
*[[Samarium]] is a radioactive drug that targets areas where bone cells growing, such as tumor cells in the [[bone]].
*It helps relieve pain caused by cancer in the bone.
*It also kills the blood cells in [[bone marrow]].
*Treatment with [[samarium]] may be followed by stem cell transplant.
*Before treatment with [[samarium]], stem cells (immature blood cells) are removed from the blood or bone marrow of the patient and are frozen and stored. After treatment with [[samarium]] is complete, the stored stem cells are thawed and given back to the patient through an infusion. These re-infused stem cells grow into (and restore) the body's blood cells.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category:Disease]]
[[Category:Musculoskeletal Disease]]
[[Category:Orthopedics]]
[[Category:Mature chapter]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Orthopedics]]

Latest revision as of 13:08, 18 October 2019


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].

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Overview

The predominant therapy for osteosarcoma is neoadjuvant chemotherapy (chemotherapy given before surgey) followed by surgical resection. The most common drugs used to treat osteosarcoma are cisplatin, doxorubicin and high-dose methotrexate. Ifosfamide can be used as an adjuvant treatment if the necrosis rate is low. Samarium is a radioactive drug that targets areas where bone cells growing, such as tumor cells in the bone. It relieves bone pain.

Medical Therapy

The osteosarcoma treatment should be determined According to:[1][2][3][3][4][5][6][7][8]

Accordingly, up to this time the available treatment for osteosarcoma is one of a combination of the following treatments:

However, the current standard treatment for osteosarcoma is to use neoadjuvant chemotherapy (chemotherapy given before surgery) followed by surgical resection.

Chemotherapy regimens

Samarium

  • Samarium is a radioactive drug that targets areas where bone cells growing, such as tumor cells in the bone.
  • It helps relieve pain caused by cancer in the bone.
  • It also kills the blood cells in bone marrow.
  • Treatment with samarium may be followed by stem cell transplant.
  • Before treatment with samarium, stem cells (immature blood cells) are removed from the blood or bone marrow of the patient and are frozen and stored. After treatment with samarium is complete, the stored stem cells are thawed and given back to the patient through an infusion. These re-infused stem cells grow into (and restore) the body's blood cells.

References

  1. ↑ Bishop MW, Janeway KA, Gorlick R (February 2016). "Future directions in the treatment of osteosarcoma". Curr. Opin. Pediatr. 28 (1): 26–33. doi:10.1097/MOP.0000000000000298. PMC 4761449. PMID 26626558.
  2. ↑ Szewczyk M, Lechowski R, Zabielska K (March 2015). "What do we know about canine osteosarcoma treatment? Review". Vet. Res. Commun. 39 (1): 61–7. doi:10.1007/s11259-014-9623-0. PMC 4330401. PMID 25422073.
  3. ↑ 3.0 3.1 Biazzo A, De Paolis M (December 2016). "Multidisciplinary approach to osteosarcoma". Acta Orthop Belg. 82 (4): 690–698. PMID 29182106.
  4. ↑ Selmic LE, Griffin LR, Rector MH, Lafferty M, Pool R, Ehrhart NP (September 2016). "Treatment of extraskeletal osteosarcoma at a previous injection site resulting in prolonged survival in 1 dog". Can. Vet. J. 57 (9): 950–4. PMC 4982565. PMID 27587886.
  5. ↑ Swift KE, LaRue SM (March 2018). "Outcome of 9 dogs treated with stereotactic radiation therapy for primary or metastatic vertebral osteosarcoma". Vet Comp Oncol. 16 (1): E152–E158. doi:10.1111/vco.12362. PMID 29181871.
  6. ↑ Redondo A, Cruz J, Lopez-Pousa A, Barón F (December 2013). "SEOM clinical guidelines for the treatment of osteosarcoma in adults-2013". Clin Transl Oncol. 15 (12): 1037–43. doi:10.1007/s12094-013-1087-0. PMID 23907290.
  7. ↑ Gill J, Ahluwalia MK, Geller D, Gorlick R (January 2013). "New targets and approaches in osteosarcoma". Pharmacol. Ther. 137 (1): 89–99. doi:10.1016/j.pharmthera.2012.09.003. PMID 22983152.
  8. ↑ Meyers PA (2015). "Systemic therapy for osteosarcoma and Ewing sarcoma". Am Soc Clin Oncol Educ Book: e644–7. doi:10.14694/EdBook_AM.2015.35.e644. PMID 25993235.

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