Table 2. Treatment Options for Osteosarcoma and Undifferentiated Pleomorphic Sarcoma (UPS) of Bone

Treatment GroupTreatment Options
Localized osteosarcoma and UPS of boneSurgical removal of primary tumor.
Chemotherapy.
Radiation therapy, if surgery is not feasible or surgical margins are inadequate.
Osteosarcoma and UPS of bone with metastatic disease at diagnosis:Chemotherapy.
Lung-only metastasesPreoperative chemotherapy followed by surgery to remove the tumor followed by postoperative combination chemotherapy.
Bone metastases with or without lung metastasesPreoperative chemotherapy followed by surgery to remove the primary tumor and all metastatic disease followed by postoperative combination chemotherapy.
Surgery to remove the primary tumor followed by chemotherapy and then surgical resection of metastatic disease followed by postoperative combination chemotherapy.
Resection of metastatic bone lesions if possible.
Radiation therapy to the extremities (may offer some local control).
Recurrent osteosarcoma and UPS of bone:Surgery to remove all sites of metastatic disease.
Chemotherapy and targeted therapy.
Radiopharmaceuticals and radiation therapy.
Local recurrenceSurgery to remove the tumor.
Lung-only recurrenceSurgery to remove the tumor.
Targeted therapy (sorafenib and regorafenib).
Recurrence with bone-only metastasesSurgery to remove the tumor.
153Sm-EDTMP with or without stem cell support.
Targeted therapy (sorafenib and regorafenib).
Radiation therapy.
Second recurrence of osteosarcomaSurgery to remove the tumor and/or chemotherapy.
Targeted therapy (sorafenib and regorafenib).
153Sm-EDTMP = samarium Sm 153-ethylenediamine tetramethylene phosphonic acid.

From: Osteosarcoma and Undifferentiated Pleomorphic Sarcoma of Bone Treatment (PDQ®)

Cover of PDQ Cancer Information Summaries
PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
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