Current therapeutic approaches of bone sarcomas

Current treatments for bone sarcomas include limb-salvage surgery with wide-margin resection or amputation, with or without adjuvant treatments including chemotherapy and radiation therapy according to the tumor's histology. Patients with locally or distally advance sarcomas may benefit from palliative treatments. Surgery is the primary therapeutic approach. In patients with high-grade tumors, those with metastases at presentation or local recurrence, and poor responders to first line treatment a carefully planned approach with target treatments or early amputation is paramount. Chemotherapy is a cornerstone of bone sarcoma treatment and is usually applied in a neoadjuvant scheme. New formulations of chemotherapeutic agents are currently available in order to reduce the cardiotoxicity of conventional regimens. Radiation can be administered as preoperative, intraoperative, postoperative (external beam radiation therapy or brachytherapy), or primary (usually palliative) depending on the site and type of the tumor, the achieved surgical margins of resection, and the response to chemotherapy. Recognition of the importance of rehabilitation services for cancer patients has increased in recent years, and sarcoma survivors benefit from multidisciplinary rehabilitation care.