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Osteosarcoma and the use of high-dose chemotherapy: Osteosarcoma and the use of high-dose chemotherapy Expert commentary Sandra Strauss Expert commentary Sandra Strauss 

Osteosarcoma and the use of high-dose chemotherapy: Osteosarcoma and the use of high-dose chemotherapy Expert commentary Sandra Strauss Expert commentary Sandra Strauss
Chapter:
Osteosarcoma and the use of high-dose chemotherapy: Expert commentary Sandra Strauss
Source:
Challenging Concepts in Oncology
Author(s):

Kai-Keen Shiu

DOI:
10.1093/med/9780199688883.003.0017

Primary bone malignancies are rare, and it is unlikely that an oncology trainee, or even a consultant, will have been involved closely in the care of a patient with this diagnosis, unless they have worked within a specialist sarcoma unit. However, due to the centralization of specialist care, patients may present to local non-specialist hospitals with complications of treatment or progression of disease. The principles of management of these rare tumours require timely, but safe, delivery of intensive, combination chemotherapy, specialist orthopaedic surgery, and a potentially aggressive approach to resection of metastatic disease. Furthermore, the majority of patients are young and should be managed within specialist services with age-appropriate care facilities. As management involves high doses of potentially toxic therapies, the complications of high-dose methotrexate and ifosfamide are discussed in this chapter. These are usually, but not always, managed within a specialist centre, so all involved in their care should be aware of, and be able to, act upon/seek appropriate specialist advice.

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