Therapeutic targets
- Relief of pain
- Stabilization of bone sections at risk of fracture
- Reduction of tumor size – preoperatively (before surgery) by radiotherapy (radiotherapy) or chemotherapy (neoadjuvant chemotherapy).
- Removal of the tumor – see “Surgical therapy“.
- Healing
Therapy recommendations
Therapy depends on the type and extent of the bone tumor. Most often, therapy consists of a combination of surgery, chemotherapy (synonym: cytostatic therapy) and radiatio (radiotherapy). The duration of total therapy is approximately 8-12 months.
- Analgesia according to WHO staging scheme:
- Non-opioid analgesic (paracetamol, first-line agent).
- Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic.
- High-potency opioid analgesic (eg, morphine) + non-opioid analgesic.
- Chemotherapeutic agents are used as an independent form of therapy with a curative (curative) or palliative (palliative; without a curative approach) approach in the therapy of the following malignant (malignant) bone tumors.
Therapy procedure
- due tohigh risk of metastases (formation of daughter tumors) and to reduce the tumor mass before surgery, chemotherapy is given (= neoadjuvant chemotherapy; induction chemotherapy).
- Note: In patients with painful spontaneous fracture, preoperative chemotherapy may be omitted.
- Followed by tumor extirpation (surgical removal of the tumor); depending on the location of the tumor and the patient’s health status, radiotherapy may be performed instead of surgery.
- Postoperatively, a further chemotherapy (= adjuvant chemotherapy) takes place.
A standardized therapy protocol is, for example, EURO EWING 99.
