What Is the Treatment of Osteosarcoma in Patients Over 40 Years With High-Grade Resectable Tumour?

This protocol covers the management of high-grade osteosarcoma presenting as a resectable tumour in patients older than 40 years — a clinical scenario where patient age is a recognised factor in treatment selection.

Clinical Scenario

Conventional osteosarcoma is always high-grade. When the tumour is resectable and the patient is over 40 years of age, this combination of features directly shapes preferred treatment choices. Evidence-based regimens for this age group are distinct from those used in younger patients.

Treatment Approach

Chemotherapy is a key component of management in this setting, with more than one regimen option available depending on clinical context. Radiotherapy may also have a role in certain situations.

The complete regimen selection, sequencing, and criteria are available in the full protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2021.08.1995

Conventional osteosarcoma is always high-grade.
In patients >40 years, preferred regimens combine doxorubicin, cisplatin and ifosfamide [III, B].
Treatment choice may take into account prior DFS, ChT regimens previously used and often includes ifosfamide or cyclophosphamide, possibly in association with etoposide and/or carboplatin [III, B], and other active drugs including gemcitabine and docetaxel [IV, C].
RT may have a role in palliation.

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