Treatment pathway of bone sarcoma in children, adolescents, and young adults.
When pediatric, adolescent, and young adult patients present with a bone sarcoma, treatment decisions, especially after relapse, are complex and require a multidisciplinary approach. This review presents scenarios commonly encountered in the therapy of bone sarcomas with the goal of objectively presenting a consensus, multidisciplinary management approach. Little variation was found in the authors' group with respect to local control or systemic therapy. Clinical trials were universally prioritized in all settings. Decisions regarding relapse therapies in the absence of a clinical trial had very minor variations initially, but a consensus was reached after a literature review and discussion. This review presents a concise document and figures as a starting point for evidence-based care for patients with these rare diseases. This framework allows prospective decision making and prioritization of clinical trials. It is hoped that this framework will inspire and focus future clinical research and thus lead to new trials to improve efficacy and reduce toxicity. Cancer 2017;123:2206-2218. © 2017 American Cancer Society.
Sarcoma Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Adolescent and Young Adult Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Damon R
http://orcid.org/0000-0002-8238-2465
DR
Reed
Division of Pediatric Oncology, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland.
Masanori
M
Hayashi
Division of Pediatric Hematology/Oncology, University of Kentucky, Lexington, Kentucky.
Lars
L
Wagner
Sarcoma Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Adolescent and Young Adult Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Department of Orthopedic Surgery, University of South Florida College of Medicine, Tampa, Florida.
Odion
O
Binitie
Division of Pediatric Oncology, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland.
Diana A
DA
Steppan
Sarcoma Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Andrew S
AS
Brohl
Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
Eric T
ET
Shinohara
Department of Pathology and Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, Nebraska.
Julia A
JA
Bridge
Division of Pediatric Oncology, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland.
David M
DM
Loeb
Division of Pediatric Hematology-Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Scott C
http://orcid.org/0000-0002-1721-1520
SC
Borinstein
Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut.
Michael S
MS
Isakoff
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D002648:Child; D000066491:Clinical Decision-Making; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D019637:Orthopedic Procedures; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D010348:Patient Care Team; D011878:Radiotherapy; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
Ewing sarcoma; adolescent and young adult (AYA); chemotherapy; osteosarcoma; pathways; pediatric