Osteosarcoma medical therapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Medical Therapy
Current standard treatment 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, muramyl tri-peptite (MTP).
Ifosfamide can be used as an adjuvant treatment if the necrosis rate is low.
3-year event free survival ranges from 50% to 75% and 5-year survival ranges from 60% to 85% in some studies. Osteosarcoma has one of the lowest survival rates for pediatric cancer despite chemotherapy's success in osteosarcoma of 6 chemotherapies, interferon-alpha, interleukin-2, and being the prototype of solid tumors in cancer.
Fluids are given for hydration.
Drugs like Kytril and Zofran help with nausea and vomiting.
Neupogen, epogen, Neulasta help with white blood cell counts and neutrophil counts.
Blood helps with anemia.
Samarium
- Samarium is a radioactive drug that targets areas where bone cells growing, such as tumor cells in bone.
- It helps relieve pain caused by cancer in the bone and it also kills bloodcells 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 bonemarrow 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.