Chemotherapy prior to surgery has been found to help with surgical removal by shrinking the tumor. With surgery alone, in more than 80% of patients the tumor came back, most often appearing in their lungs. The high recurrence rate indicates that most patients have micrometastatic disease at diagnosis, meaning they have metastases that are too small to be seen in their lungs with the imaging studies. Therefore, the use of chemotherapy before surgery is a critical part of the treatment of patients with osteosarcoma.
There are a few different ways that chemotherapy is given:
Intravenously (IV): A needle is inserted into the vein and the chemotherapy medications flow from an IV bag into the bloodstream. A central venous catheter, which is a tube that is placed into a vein in your chest around the time of biopsy, can be used to directly insert the medication into the vein without sticking you with a needle.
Orally: Some non-chemo medications, like anti-nausea medications, are given in pill form to be swallowed.
Chemotherapy drugs can be used in different combinations and at different times, depending on the protocol that your doctor has selected. Some medications that your doctor may prescribe for you include:
- High-dose methotrexate
- Doxorubicin (Adriamycin)
- Cisplatin
- Ifosfamide
- Etoposide
