title: Intra-arterial chemotherapy for limb preservation in patients with osteosarcoma: nursing implications.
abstract: Osteosarcoma is an aggressive tumor found in children and young adults, originating primarily in the legs or arms. The high-grade tumor grows in a circular, ball-like mass in the bone tissue. Before the 1970s and the advent of chemotherapy use in osteosarcoma, treatment consisted solely of amputation. More recently, a preoperative regimen of intra-arterial (IA) cisplatin and infusional doxorubicin with limb-sparing procedures has provided an effective treatment option and improved survival for many patients with osteosarcoma. IA chemotherapy is administered through a small, temporary, external catheter that rests in the arterial vessel that supplies the tumor. The primary advantage of IA chemotherapy administration is the delivery of a higher chemotherapy concentration directly to the tumor site, Nursing management of patients with IA chemotherapy requires knowledge of treatment side effects and procedure-related assessments. Further implications for practice include instructing patients and families before and after the insertion of the IA line and giving discharge and long-term follow-up education. Oncology nurses are well positioned to assist children and young adult patients through difficulties with adjustment after treatment is completed and a response has been achieved, owing to advanced communication skills and knowledge of developmental stages and survivorship issues,
authors.affiliation: School of Nursing, University of Colorado, Denver, USA. ellyn.matthews@uchsc.edu
authors.forename: Ellyn
authors.initials: E
authors.lastname: Matthews
authors.forename: Katie
authors.initials: K
authors.lastname: Snell
authors.forename: Heather
authors.initials: H
authors.lastname: Coats
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005121:Extremities; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D024802:Nurse's Role; D009730:Nursing Assessment; D009859:Oncology Nursing / Q000379:methods*; D012516:Osteosarcoma / Q000401:mortality / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration; D010351:Patient Discharge; D010353:Patient Education as Topic; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods / Q000451:nursing* / Q000523:psychology; D016879:Salvage Therapy / Q000379:methods / Q000451:nursing* / Q000523:psychology; D015996:Survival Rate
chemical_list: D004317:Doxorubicin; D002945:Cisplatin