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Review
. 2017 Jun 15;123(12):2206-2218.
doi: 10.1002/cncr.30589. Epub 2017 Mar 21.

Treatment pathway of bone sarcoma in children, adolescents, and young adults

Damon R Reed  1   2   3 , Masanori Hayashi  4 , Lars Wagner  5 , Odion Binitie  1   3   6 , Diana A Steppan  4 , Andrew S Brohl  1   2 , Eric T Shinohara  7 , Julia A Bridge  8 , David M Loeb  4 , Scott C Borinstein  9 , Michael S Isakoff  10
Affiliations
Review

Treatment pathway of bone sarcoma in children, adolescents, and young adults

Damon R Reed et al. Cancer. .

Abstract

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.

Keywords: Ewing sarcoma; adolescent and young adult (AYA); chemotherapy; osteosarcoma; pathways; pediatric.

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Figures

Figure 1
Figure 1
Workup for newly suspected bone sarcoma. CBC indicates complete blood count; CMP, complete metabolic panel; CT, computed tomography; GFR, glomerular filtration rate; LDH, lactate dehydrogenase; MRI, magnetic resonance imaging; PET, positron emission tomography.
Figure 2
Figure 2
Pathway for treating newly diagnosed and relapsed osteosarcoma. CIVI indicates continuous intravenous infusion; CR, complete response; IE, ifosfamide and etoposide; MAP, methotrexate, doxorubicin, and cisplatin; PD, progressive disease; PR, partial response; SD, stable disease.
Figure 3
Figure 3
Pathway for treating newly diagnosed and relapsed Ewing sarcoma. CR, complete response; IE, ifosfamide and etoposide; PD, progressive disease; PR, partial response; SD, stable disease; VDC, vincristine, doxorubicin, and cyclophosphamide; XRT, X‐ray therapy.
Figure 4
Figure 4
Recommendations for tumor surveillance after treatment. CBC indicates complete blood count; CMP, complete metabolic panel; CT, computed tomography; CXR PA, chest X‐ray, posterior anterior; PET, positron emission tomography.
See this image and copyright information in PMC

References

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