Osteosarcoma is renowned for early haematogenous spread to the lungs, and requires multi-modality therapy to achieve a cure.

Historical Treatment

The principle treatment before development of radio- and chemotherapy was surgical amputation of the affected limb. This was associated with survival in the order of 20%, with most patients suffering from relapse in the lungs and dying from their disease. Local control is close to 100% so long as clear margins are obtained.
Radiotherapy offered the option of short term local control in these patients, allowing themselves to declare their metastatic disease and avoiding an unhelpful amputation. This technique was pioneered by Sir Cade and involved delivery of doses above 50 Gy; local control was very effective for the 6 months post treatment. Surgery was performed after 6 months in those patients who remained well.
The development of systemic therapies led to a complete rethinking of treatment of osteosarcoma and combined modality treatment persists to this day.

Localised Disease

Metastatic Disease

Specialist Topics