Treatment of recurrent osteosarcoma

Osteosarcoma is a clinically malignant tumor. When hearing the word "malignant tumor", many patients will be very scared. Because of the fear, they do not actively seek treatment, which leads to recurrence after multiple treatments. In fact, patients do not need to panic. Osteosarcoma is not an incurable disease. There are many treatments for osteosarcoma, and it can also improve the survival rate of patients. So what are the treatments for recurrent osteosarcoma? Let us introduce them in detail below.

After the patient's condition is diagnosed, amputation or joint separation should be performed as soon as possible. Chemotherapy and radiotherapy before and after the operation may improve the efficacy. The effect of chemotherapy or radiotherapy alone is not great.

The treatment of osteosarcoma is a comprehensive treatment with surgery as the main method, that is, preoperative chemotherapy, surgery, and postoperative chemotherapy. A considerable number of cases (about 66%) have satisfactory chemotherapy effects. Chemotherapy greatly improves the survival rate by inhibiting the occurrence of lung metastasis, and chemotherapy greatly increases the chance of limb-saving surgery without the need for amputation. For typical osteosarcoma, if the preoperative chemotherapy is effective, extensive large-scale resection can be performed. However, if chemotherapy is ineffective, radical resection or amputation should be performed. Lung metastases can often be treated with resection.

1. Biopsy: Only with a clear histological diagnosis can the treatment plan be determined. Preoperative biopsy is very important and is part of surgical treatment. It should be performed by experienced doctors, because inappropriate biopsy can lose the opportunity to preserve the limb. Needle aspiration biopsy has the advantages of little contamination and low risk. Its diagnostic positive rate can be as high as 80% or more in experienced hospitals. If needle aspiration biopsy fails, an incisional biopsy should be performed as soon as possible. The incision for incisional biopsy is usually longitudinal and can be removed together with the tumor during surgery.

2. Chemotherapy: Chemotherapy is an important adjuvant treatment for osteosarcoma. High-dose chemotherapy combined with multiple drugs can kill the tumor locally. Preoperative chemotherapy (neoadjuvant chemotherapy) can cause tumor cell necrosis, tumor shrinkage, disappearance of edema and new tumor blood vessels in the reaction area, and clearer boundaries of tumor calcification. Clinically, the patient's pain is reduced or disappears, the tumor becomes smaller, the joint range of motion increases, and AKP can be reduced to normal.

High-dose chemotherapy is also an effective method for systemic treatment of osteosarcoma. Chemotherapy can kill micro-metastases in the lungs and throughout the body. This treatment should be performed early. Micro-lesions are more sensitive to chemotherapy than large tumors. Adjuvant chemotherapy can reduce the number of tumors in the lungs and delay their appearance. The key to prolonging the survival of patients with lung metastases is to completely remove the metastases. Chemotherapy can promote the radical cure of the entire disease and increase the cure rate. 20% to 40% of patients abroad can be cured through multiple treatments.