Osteosarcomas account for approximately 60% of malignant bone tumors in the first two decades of life.Peak incidence occurs during the pubescent growth spurt (ages 15 to 19 years) in the metaphyses of the most rapidly growing bones.
TRADITIONAL TREATMENT
Virtually all patients with osteosarcoma have subclinical micrometastatic disease.Thus treatment should include surgical ablation (amputation or limb-sparing resection) and chemotherapy to eradicate micrometastases.
Surgical ablation
Both amputation and limb-salvage operation are the choice approaches.Limb-sparing surgery is now the preferred approach for the majority (more than 70%)of patients with osteosarcoma,as it achieves a better functional outcome.
Chemotherapy
For the majority of patients,neoadjuvant chemotherapy should be initiated as soon as possible after establishment of diagnosis of osteosarcoma,and should be continued for approximately 9 to 12 weeks before definitive surgery of the primary tumor.Postoperatively,chemotherapy is resumed for an additional 35 to 40 weeks.
NOVAL THERAPIES
Cryoablation: Under CT or ultrasound guidance, freezing probe insert into cancerous mass to ablate tumor.
|
