Are osteosarcomas sensitive to radiotherapy and chemotherapy?

Written by Fang Da Zheng
Orthopedics
Updated on December 07, 2024
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Osteosarcoma is generally insensitive to radiotherapy, hence radiation therapy is not used for such diseases in clinical settings. Similarly, these diseases have a moderate sensitivity to chemotherapy, necessitating the use of relatively high doses of chemotherapy during treatment. The main mechanism of chemotherapy involves using a series of cytotoxic drugs to inhibit tumor growth. Although high-dose chemotherapy can effectively kill tumor cells, it can also damage some of the patient's normal cells, leading to severe reactions. If radical surgery is viable for these patients, then curative surgery is the preferred method of treatment.

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Written by Wang Cheng Lin
Orthopedics
48sec home-news-image

Osteosarcoma etiology

Currently, in clinical practice, the pathogenesis of osteosarcoma is not fully understood. However, it may be related to genetics, exposure to radioactive materials, and viral infections. It can also be secondary to other deformative osteitis, fibrous dysplasia, and some benign tumors transforming into malignant bone tumors. Osteosarcoma primarily occurs in the metaphysis of long bones. The tumor spreads along the marrow cavity, extending towards both the metaphysis of the long bones and the diaphysis of the bones. Once the tumor breaks through the bone shaft, it rapidly destroys the cortical bone, spreads under the periosteum, and invades the surrounding soft tissues outside the eardrum, damaging the surrounding muscles and soft tissues.

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Written by Na Hong Wei
Orthopedics
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Is there a cure for osteosarcoma?

Osteosarcoma is treatable, but it requires proper medical treatment. Currently, adjuvant chemotherapy significantly improves the five-year survival rate for osteosarcoma. The main treatment approach is still surgery as part of a comprehensive therapy. Specifically, the first step involves adequate preoperative chemotherapy, generally no fewer than six sessions over about eight weeks, or approximately two months. After this, patients often experience reduced pain, weight gain, improved positioning of the tumor, and a decrease in tumor size. Depending on the specific situation, a decision is made on the type of surgery to be performed—whether to amputate, preserve the limb, install a prosthetic, or use artificial bone as a replacement. Postoperative chemotherapy is usually also required to help ensure that the tumor does not recur and to increase the five-year or ten-year survival rate. Therefore, the current five-year survival rate for osteosarcoma has increased from the previous 40%-50% to about 80%. So, as long as one chooses the right hospital and the right treatment plan, and maintains confidence, osteosarcoma is usually treatable.

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Written by Wang Cheng Lin
Orthopedics
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What are the symptoms of osteosarcoma?

Symptoms of Osteosarcoma: The first is pain at the site of occurrence. This pain may be intermittent and not very pronounced in the early stages. As the condition progresses, the severity of the pain gradually increases, transitioning from intermittent to persistent pain; The second is the formation of a lump. You can feel a lump on the limb with your hand, and this lump is clearly tender to the touch; The third is limping, which is mainly caused by the pain in the limb; The fourth is the most common systemic symptoms. Patients with this malignant tumor will exhibit fever, weight loss, anemia, and pathological fractures. These are the main symptoms of osteosarcoma currently observed in clinical settings.

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Written by Na Hong Wei
Orthopedics
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Osteosarcoma diagnostic methods

Osteosarcoma Diagnostic Methods: In clinical practice, once osteosarcoma is suspected in a patient, the diagnostic approach, as per the Chinese Cancer Treatment Guidelines, requires a combination of clinical symptoms, radiological data, and pathology. Only through the integration of these three elements can a definitive diagnosis of osteosarcoma be established. Reliance solely on pathology, or exclusively on radiologic examination or clinical examination, can lead to biased results. Given that immediate treatment is crucial upon the discovery of osteosarcoma, and considering the severe implications of treatment costs, patient suffering, and other related issues, it is vital that the diagnosis of osteosarcoma is error-free. To ensure absolute certainty, the approach should involve clinical symptoms supplemented by necessary auxiliary examinations such as X-rays and CT or MRI scans, followed by a diagnostic biopsy for pathological results. This comprehensive combination generally prevents the occurrence of missed or misdiagnoses in patients with osteosarcoma. Therefore, the confirmatory diagnosis of osteosarcoma should not rely solely on one type of examination but should combine clinical assessment with necessary imaging data and pathology to finalize the diagnosis process.

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Written by Li Jie
Orthopedics
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incidence of osteosarcoma

Osteosarcoma, also known as osteogenic sarcoma, is a primary malignant tumor of the bone and has a relatively high incidence rate. Among primary bone tumors, the incidence of osteosarcoma is second only to plasma cell myeloma, ranking second. Osteosarcoma typically occurs in tubular bones, commonly affecting the rapidly growing metaphyseal regions. The distal femur, proximal tibia, and proximal humerus are the most frequently affected sites. Between 50%-70% of all cases occur around the knee joint. The common age range for this disease is between 10 to 20 years old, with a higher prevalence in males than in females.