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

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


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.

Publication types

  • Consensus Development Conference
  • Review

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / pathology
  • Bone Neoplasms / therapy*
  • Child
  • Clinical Decision-Making*
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Humans
  • Neoplasm Recurrence, Local / therapy*
  • Orthopedic Procedures*
  • Osteosarcoma / diagnostic imaging
  • Osteosarcoma / pathology
  • Osteosarcoma / therapy*
  • Patient Care Team
  • Radiotherapy*
  • Sarcoma / diagnostic imaging
  • Sarcoma / pathology
  • Sarcoma / therapy
  • Sarcoma, Ewing / diagnostic imaging
  • Sarcoma, Ewing / pathology
  • Sarcoma, Ewing / therapy*
  • Young Adult