Osteosarcoma
Osteogenic Sarcoma is one of the most common bone tumours and they have a high risk for spreading into the lungs. Hence, along with local therapy like resection, there is also a need for chemotherapy to prevent distant metastases. They are considered chemoresistant tumours and usually, combination chemotherapy is used. There are two major regimens used: High Dose Methotrexate based and Combination therapy with Ifosfamide/Cisplatin/Doxorubicin. The chemotherapy cycles are usually given before surgery as neoadjuvant chemotherapy and after surgery as adjuvant chemotherapy. Both regimens need supportive medications like filgrastim support, antiemeticsetc for decreasing the chances of side effects. In the case of metastatic Osteosarcoma, the initial treatment includes chemotherapy and reassessment. If at reassessment the metastatic lesions (lung) are resectable, then they are removed and chemotherapy is continued.
Ewings sarcoma
Chemotherapy is part of the standard treatment for Ewings sarcoma. They are usually seen in the adolescent and young adult population. After complete staging works up, they are given induction chemotherapy and then taken up for local treatment. The local treatment is either surgery (in case of peripheral lesions) or radiotherapy (pelvic lesions) or both (in case of chest wall Tumours). The total treatment duration is long: 9-12 months as per the treatment protocols. Usually, the treatment is well tolerated by young patients. After treatment, it is very important to be on long term follow up so that any long term treatment-related side effects can be managed promptly. They are highly curative Tumours with proper treatment.
Other bone Tumours
Treatment of chondrosarcoma and most other benign Tumours of bone remains predominantly surgical, although chemotherapy may have a role in dedifferentiated and mesenchymal subtypes. They are usually considered chemoresistant. Incase of low-grade chondrosarcoma, an observation also is an option unless they are symptomatic.
Currently, there is no much role for Targeted therapy in Bone tumours