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Royal Orthopaedic Hospital Child Bear

Treatment

The treatment of Osteosarcoma includes surgery, radiotherapy and chemotherapy - the combination of treatment/s being specific to the individual case however the complete removal of the tumour and surrounding bone is required to prevent local tumour recurrence.

Before the 1970s, amputation was the only surgical approach and in some cases, amputation is still necessary. Currently however, 95% of patients with localized Osteosarcoma of the extremity can be considered for limb-salvage surgery. Limb-salvage surgery is where the affected area and surrounding tissues are removed and the bone is replaced with either metal replacement prosthesis or a bone graft. If the cancer affects a bone near a joint then the whole joint is replaced with an artificial one.

When Osteosarcoma is treated by surgery alone, the natural history is recurrence and more than 80% of patients will develop metastatic disease. The use of multi-agent chemotherapy has markedly improved the outcome of patients with Osteosarcoma.

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells and it is usually given before surgery and may shrink large tumors’ enough to avoid amputation. The course of chemotherapy continues after surgery to destroy any remaining cancer cells and to stop the sarcoma from spreading outside the bone (adjuvant chemotherapy). Chemotherapy has a number of related side effects which are specific to each individual.

Radiotherapy treats cancer by using high energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy is sometimes used after surgery and may be used to treat the primary tumour where surgery is not possible. Again radiotherapy has a number of listed side effects depending upon the course of treatment engaged.



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