Primary bone osteosarcoma in the pediatric age: state of the art.
The current combination treatment, chemotherapy and surgery, has significantly improved the cure rate and the survival rate of primary bone osteosarcoma. The 5-year survival rate has increased in the last 30 years from 10% to 70%. Even in patients with poor prognosis, such as those with metastases at diagnosis, the 5-year survival rate has reached 20-30% due to chemotherapy and the surgical removal of metastases and primary tumor. However, the most effective drugs are still the same as those employed over the last 20 years as front line neoadjuvant or adjuvant chemotherapy: Doxorubicin, Cisplatin, Methotrexate, Ifosfamide. No standard, second line therapy exists for those who relapse. At relapse, due to the lack of new non-cross-resistant drugs, surgery is still the main option when feasible. Other drugs have been employed in relapsed patients with poor results. This article reviews the state of the art of treatment for bone osteosarcoma in the pediatric age.
Longhi
Alessandra
A
Chemotherapy Surgery of the Musculoskeletal, Oncology Department at Rizzoli Orthopaedic Institute, Bologna, Italy. alessandra.longhi@ior.it
Errani
Costantino
C
De Paolis
Massimiliano
M
Mercuri
Mario
M
Bacci
Gaetano
G
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D002648:Child; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D015996:Survival Rate