title: Management of osteosarcoma.
abstract: Improving cure rates for osteosarcoma continues to be a major challenge. The clinical management of individual patients is exacting and requires a skilled, experienced team including a surgeon, pathologist, oncologist, and radiologist, with support from specialist nurses and rehabilitation teams. Outcomes from treatment have improved little in 20 years and remain disappointing. Chemotherapy for osteosarcoma is among the most grueling of any given for solid tumors, and treatment of the primary tumor is associated with permanent disability of some degree in a significant proportion of patients. New systemic treatments remain beyond the horizon. In recognition of these difficulties, an international cooperation has begun with the opening of a randomized trial, European and American Osteosarcoma (EURAMOS) 1, in Europe and the United States. This study heralds a new era of clinical investigation into osteosarcoma, with the promise of valuable biologic insights and rapid evaluation of investigational strategies. Osteosarcoma should always be treated under the guidance of a specialist team, and we recommend that whenever possible, patients be offered entry into EURAMOS 1 or other well-designed clinical trials.
authors.affiliation: Department of Oncology, University College Hospital, 250 Euston Road, London NW1 2PG, UK. jeremy.whelan@uclh.nhs.uk
authors.forename: Jeremy
authors.initials: J
authors.lastname: Whelan
authors.forename: Beatrice
authors.initials: B
authors.lastname: Seddon
authors.forename: Martha
authors.initials: M
authors.lastname: Perisoglou
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D006801:Humans; D012516:Osteosarcoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016032:Randomized Controlled Trials as Topic