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Thiruvengadam S, Lam M, Honeybul S. Metastatic intradural primary spinal osteosarcoma: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2024; 7:CASE2480. [PMID: 38621306 PMCID: PMC11023006 DOI: 10.3171/case2480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/13/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Osteosarcomas are a common primary bone neoplasm among adolescents but represent 0.2% of all malignancies with an incidence of two to four cases per million persons annually worldwide. Although known to have significant metastatic potential, its rare incidence, treatment resistance, and poor prognosis have rendered it a poorly understood and infrequently documented pathology. OBSERVATIONS Herein the authors present the first documented case of lumbosacral intradural metastasis of a primary osteosarcoma in a young patient, possibly via intradural dissemination following pinhole durotomy in a prior thoracic surgery. LESSONS Osteosarcomas remain a difficult pathology to treat, particularly upon metastatic dissemination. The utility of adjuvant radiotherapy after resection of an osteosarcoma is increasingly evident in the reduction of local recurrence. In the context of intraoperative pinhole durotomies in resections of high-grade lesions, due consideration should be given to whole-spine radiation, although this remains an evidence-free zone.
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Ahmed SK, Petersen IA, Grams MP, Finley RR, Haddock MG, Owen D. Spatially Fractionated Radiation Therapy in Sarcomas: A Large Single-Institution Experience. Adv Radiat Oncol 2024; 9:101401. [PMID: 38495033 PMCID: PMC10943518 DOI: 10.1016/j.adro.2023.101401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/16/2023] [Indexed: 03/19/2024] Open
Abstract
Purpose Spatially fractionated radiation therapy (SFRT) is a recognized technique for enhancing tumor response in radioresistant and bulky tumors. We analyzed clinical and treatment outcomes in patients with bone and soft tissue sarcomas treated with modern SFRT techniques. Methods and Materials Patients with metastatic or unresectable sarcoma treated with brass collimator, volumetric modulated arc therapy lattice, or proton SFRT from December 2019 to June 2022 were retrospectively reviewed. Consolidative external beam radiation therapy (EBRT) was delivered at the physician's discretion. Patient and treatment characteristics, treatment response (symptom improvement, local control, and imaging response), and toxicity data were collected. Results The cohort consisted of 53 patients treated with 61 SFRT treatments. Median age at treatment was 60.0 years. The primary location was soft tissue in 46 courses (75%) and bone in 15 (25%). Fifty-three courses (87%) were treated for symptom relief. The most used SFRT technique was volumetric modulated arc therapy lattice (n = 52, 85%) to a dose of 20 Gy (n = 48, 79%; range, 16-20 Gy). EBRT was delivered post-SFRT in 55 (90%) treatment courses with a median time interval from SFRT to EBRT of 5 days (range, 0-14 days). Median physical EBRT dose and fractionation was 40 Gy (range, 9-73.5 Gy) and 10 fractions (range, 3-33 fractions). Median follow up was 7.4 months (range, 0.2-30 months). One-year overall survival and local control rates were 53% and 82%. Symptom relief was documented with 32 treatment courses (60%). Stable or partial response was observed with 47 treatment courses (90%). Four grade 3 to 4 acute and subacute toxicities were attributable to SFRT (8%). Conclusions The current series is the largest to date documenting outcomes for SFRT in sarcomas. Our results suggest combined SFRT with EBRT is associated with a favorable toxicity profile and high rates of symptomatic and radiographic responses for metastatic or unresectable sarcomas.
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Affiliation(s)
- Safia K. Ahmed
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona
| | - Ivy A. Petersen
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Michael P. Grams
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Randi R. Finley
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - Dawn Owen
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
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Mettmann VL, Blattmann C, Friedel G, Harrabi S, von Kalle T, Kager L, Kevric M, Kühne T, Nathrath M, Sorg B, Werner M, Bielack SS, Hecker-Nolting S. Primary Multi-Systemic Metastases in Osteosarcoma: Presentation, Treatment, and Survival of 83 Patients of the Cooperative Osteosarcoma Study Group. Cancers (Basel) 2024; 16:275. [PMID: 38254767 PMCID: PMC10813782 DOI: 10.3390/cancers16020275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/02/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND To evaluate patient and tumour characteristics, treatment, and their impact on survival in patients with multi-systemic metastases at initial diagnosis of high-grade osteosarcoma. Precedure: Eighty-three consecutive patients who presented with multi-systemic metastases at initial diagnosis of high-grade osteosarcoma were retrospectively reviewed. In cases of curative intent, the Cooperative Osteosarcoma Study Group recommended surgical removal of all detectable metastases in addition to complete resection of the primary tumour and chemotherapy. RESULTS Eighty-three eligible patients (1.8%) were identified among a total of 4605 individuals with high-grade osteosarcoma. Nine (10.8%) of these achieved complete surgical remission, of whom seven later had recurrences. The median follow-up time was 12 (range, 1-165) months for all patients. Actuarial event-free survival after 1, 2, and 5 years was 9.6 ± 3.2%, 1.4 ± 1.4%, and 1.4 ± 1.4%, and overall survival was 54.0 ± 5.6%, 23.2 ± 4.9%, and 8.7 ± 3.3%. In univariate analyses, elevated alkaline phosphatase before chemotherapy, pleural effusion, distant bones as metastatic sites, and more than one bone metastasis were negative prognostic factors. Among treatment-related factors, the microscopically complete resection of the primary tumour, a good response to first-line chemotherapy, the macroscopically complete resection of all affected tumour sites, and local treatment (surgery ± radiotherapy) of all bone metastases were associated with better outcomes. Tumour progression under first-line treatment significantly correlated with shorter survival times. CONCLUSION The outlook for patients with multi-systemic primary metastases from osteosarcoma remains very poor. The utmost importance of surgical resection of all tumour sites was confirmed. For unresectable bone metastases, radiotherapy might be considered. In the patient group studied, standard chemotherapy was often insufficiently effective. In the case of such advanced disease, alternative treatment options are urgently required.
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Affiliation(s)
- Vanessa L. Mettmann
- Cooperative Osteosarcoma Study Group, Paediatrics 5 (Oncology, Haematology, Immunology), Centre for Paediatric, Adolescent and Women’s Medicine, and Stuttgart Cancer Centre, Klinikum Stuttgart–Olgahospital, 70174 Stuttgart, Germany
| | - Claudia Blattmann
- Cooperative Osteosarcoma Study Group, Paediatrics 5 (Oncology, Haematology, Immunology), Centre for Paediatric, Adolescent and Women’s Medicine, and Stuttgart Cancer Centre, Klinikum Stuttgart–Olgahospital, 70174 Stuttgart, Germany
| | - Godehard Friedel
- Department of Thoracic Surgery, Faculty of Science, University of Tubingen, 72076 Tubingen, Germany
| | - Semi Harrabi
- Heidelberg Ion Beam Therapy Centre (HIT), Department of Radiation Oncology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Thekla von Kalle
- Radiologic Institute, Centre for Paediatric, Adolescent and Women’s Medicine, Stuttgart Cancer Centre, Klinikum Stuttgart–Olgahospital, 70174 Stuttgart, Germany
| | - Leo Kager
- St. Anna Children’s Hospital, University Hospital for Paediatric and Adolescent Medicine of the Medical University and St. Anna Children’s Cancer Research Institute (CCRI), 1090 Vienna, Austria
| | - Matthias Kevric
- Cooperative Osteosarcoma Study Group, Paediatrics 5 (Oncology, Haematology, Immunology), Centre for Paediatric, Adolescent and Women’s Medicine, and Stuttgart Cancer Centre, Klinikum Stuttgart–Olgahospital, 70174 Stuttgart, Germany
| | - Thomas Kühne
- University Children’s Hospital Basel, 4031 Basel, Switzerland
| | - Michaela Nathrath
- Department of Paediatrics and Children’s Cancer Research Centre, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
- Paediatric Haematology and Oncology, Klinikum Kassel, 34125 Kassel, Germany
| | - Benjamin Sorg
- Cooperative Osteosarcoma Study Group, Paediatrics 5 (Oncology, Haematology, Immunology), Centre for Paediatric, Adolescent and Women’s Medicine, and Stuttgart Cancer Centre, Klinikum Stuttgart–Olgahospital, 70174 Stuttgart, Germany
| | - Mathias Werner
- Osteopathology Reference Centre, Institute of Pathology, Vivantes Klinikum im Friedrichshein, 10249 Berlin, Germany
| | - Stefan S. Bielack
- Cooperative Osteosarcoma Study Group, Paediatrics 5 (Oncology, Haematology, Immunology), Centre for Paediatric, Adolescent and Women’s Medicine, and Stuttgart Cancer Centre, Klinikum Stuttgart–Olgahospital, 70174 Stuttgart, Germany
- Department for Paediatric Haematology and Oncology, University’s Children’s Hospital Muenster, 48149 Muenster, Germany
| | - Stefanie Hecker-Nolting
- Cooperative Osteosarcoma Study Group, Paediatrics 5 (Oncology, Haematology, Immunology), Centre for Paediatric, Adolescent and Women’s Medicine, and Stuttgart Cancer Centre, Klinikum Stuttgart–Olgahospital, 70174 Stuttgart, Germany
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Ying H, Li ZQ, Li MP, Liu WC. Metabolism and senescence in the immune microenvironment of osteosarcoma: focus on new therapeutic strategies. Front Endocrinol (Lausanne) 2023; 14:1217669. [PMID: 37497349 PMCID: PMC10366376 DOI: 10.3389/fendo.2023.1217669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Osteosarcoma is a highly aggressive and metastatic malignant tumor. It has the highest incidence of all malignant bone tumors and is one of the most common solid tumors in children and adolescents. Osteosarcoma tissues are often richly infiltrated with inflammatory cells, including tumor-associated macrophages, lymphocytes, and dendritic cells, forming a complex immune microenvironment. The expression of immune checkpoint molecules is also high in osteosarcoma tissues, which may be involved in the mechanism of anti-tumor immune escape. Metabolism and senescence are closely related to the immune microenvironment, and disturbances in metabolism and senescence may have important effects on the immune microenvironment, thereby affecting immune cell function and immune responses. Metabolic modulation and anti-senescence therapy are gaining the attention of researchers as emerging immunotherapeutic strategies for tumors. Through an in-depth study of the interconnection of metabolism and anti- senescence in the tumor immune microenvironment and its regulatory mechanism on immune cell function and immune response, more precise therapeutic strategies can be developed. Combined with the screening and application of biomarkers, personalized treatment can be achieved to improve therapeutic efficacy and provide a scientific basis for clinical decision-making. Metabolic modulation and anti- senescence therapy can also be combined with other immunotherapy approaches, such as immune checkpoint inhibitors and tumor vaccines, to form a multi-level and multi-dimensional immunotherapy strategy, thus further enhancing the effect of immunotherapy. Multidisciplinary cooperation and integrated treatment can optimize the treatment plan and maximize the survival rate and quality of life of patients. Future research and clinical practice will further advance this field, promising more effective treatment options for patients with osteosarcoma. In this review, we reviewed metabolic and senescence characteristics in the immune microenvironment of osteosarcoma and related immunotherapies, and provide a reference for development of more personalized and effective therapeutic strategies.
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Affiliation(s)
- Hui Ying
- Department of Emergency Trauma Surgery, Ganzhou People’s Hospital, Ganzhou, China
- Department of Spine Surgery, Ganzhou People’s Hospital, Ganzhou, China
| | - Zhi-Qiang Li
- Department of Emergency Trauma Surgery, Ganzhou People’s Hospital, Ganzhou, China
- Department of Spine Surgery, Ganzhou People’s Hospital, Ganzhou, China
| | - Meng-Pan Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wen-Cai Liu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Zhang L, Akiyama T, Saito M, Okamoto M, Gokita T, Kobayashi H, Ae K, Ohno T. Complications and Functional Outcome Differences in Carbon Ion Radiotherapy and Surgery for Malignant Bone Tumors of the Pelvis: A Multicenter, Cohort Study. Ann Surg Oncol 2023; 30:4475-4484. [PMID: 36853566 DOI: 10.1245/s10434-023-13226-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/23/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Carbon ion radiotherapy (CIRT) is an evolving treatment option for malignant pelvic tumors in patients with poor surgical indications. However, the difference in complications and functional outcomes between CIRT and surgery is poorly understood. This study compares the complications and functional outcomes of CIRT and surgery to facilitate treatment selection. METHODS A total of 28 patients who underwent CIRT for pelvic bone tumors while theoretically meeting the surgical resection criteria were included. Sixty-nine patients who underwent surgery for pelvic bone tumors were included as controls. Major complication rates and functional outcomes (ambulatory, pain, urination, constipation) were evaluated and compared at several time points (pretreatment, discharge, and final follow-up) between the groups. RESULTS Early (within 90 days) major complications were not observed in the CIRT group but occurred in 30% of the surgery group, which was statistically significant (P < 0.001). In contrast, late (after 90 days) major complications occurred more often in the CIRT group than in the surgery group (18% and 4%, respectively; P = 0.042). From pretreatment until discharge, all functional outcomes in the surgery group deteriorated (P < 0.001 for all) but did not change in the CIRT group (P = 0.77-1.00). At the final follow-up, all functional outcomes showed no significant intergroup difference (P = 0.28-0.92) due to the recovery trend in the surgery group and the deterioration trend in the CIRT group. CONCLUSIONS Compared with surgery, CIRT may have favorable safety and stable functional outcomes in the short-term but more late complications. Mid-term functional outcomes were similar between the groups.
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Affiliation(s)
- Liuzhe Zhang
- Department of Orthopedic Surgery, Jichi Medical University Saitama Medical Center, Saitama, Japan
- Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan
| | - Toru Akiyama
- Department of Orthopedic Surgery, Jichi Medical University Saitama Medical Center, Saitama, Japan.
| | - Masanori Saito
- Department of Orthopedic Oncology, The Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Tabu Gokita
- Department of Orthopedic Oncology, Saitama Cancer Center, Saitama, Japan
| | - Hiroshi Kobayashi
- Department of Orthopedic Surgery, The University of Tokyo, Tokyo, Japan
| | - Keisuke Ae
- Department of Orthopedic Oncology, The Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
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Moukhlissi M, Mansouri H, Najioui Y, Bennani A, Berhili S, Mezouar L. Osteosarcoma of the ethmoid sinus: About a case. Radiol Case Rep 2023; 18:1617-1619. [PMID: 36865619 PMCID: PMC9971021 DOI: 10.1016/j.radcr.2023.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 02/17/2023] Open
Abstract
Osteosarcomas of the craniofacial bones account for less than 10% of all osteosarcomas. Primary osteosarcomas of the nasal cavity and paranasal sinus are rare localization (0.5%-8.1% of osteosarcomas occur in this site). Accordingly, we report a case of osteosarcoma arising de novo from the ethmoid bone in a 46-year-old female. Initially, she presented with headache, bilateral epistaxis, and postnasal drip. Biopsy revealed an osteosarcoma ethmoidal. The patient was treated by a neoadjuvant chemotherapy followed by surgical resection and radiotherapy.
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Affiliation(s)
- Mohamed Moukhlissi
- Departement of Radiotherapy, Hassan II Oncology Center, Mohammed VI University hospital Center, Mohamed First University, Oujda, Morocco,Corresponding author at: Departement of Radiotherapy, Hassan II Oncology Center, Mohammed VI University hospital Center, Mohamed First University, Oujda, Morocco.
| | - Hanane Mansouri
- Departement of Radiotherapy, Hassan II Oncology Center, Mohammed VI University hospital Center, Mohamed First University, Oujda, Morocco
| | - Younesse Najioui
- Departement of Anatomo-Pathology, Mohammed VI University hospital center, Mohamed First University, Oujda, Morocco
| | - Amal Bennani
- Departement of Anatomo-Pathology, Mohammed VI University hospital center, Mohamed First University, Oujda, Morocco
| | - Soufiane Berhili
- Departement of Radiotherapy, Hassan II Oncology Center, Mohammed VI University hospital Center, Mohamed First University, Oujda, Morocco
| | - Loubna Mezouar
- Departement of Radiotherapy, Hassan II Oncology Center, Mohammed VI University hospital Center, Mohamed First University, Oujda, Morocco
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Xiaotong S, Xiao L, Shiyu L, Zhiguo B, Chunyang F, Jianguo L. LncRNAs could play a vital role in osteosarcoma treatment: Inhibiting osteosarcoma progression and improving chemotherapy resistance. Front Genet 2023; 13:1022155. [PMID: 36726721 PMCID: PMC9885180 DOI: 10.3389/fgene.2022.1022155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
Osteosarcoma (OS) is one of the most common primary solid malignant tumors in orthopedics, and its main clinical treatments are surgery and chemotherapy. However, a wide surgical resection range, functional reconstruction of postoperative limbs, and chemotherapy resistance remain as challenges for patients and orthopedists. To address these problems, the discovery of new effective conservative treatments is important. Long non-coding RNAs (lncRNAs) are RNAs longer than 200 nucleotides in length that do not encode proteins. Researchers have recently found that long non-coding RNAs are closely associated with the development of OS, indicating their potentially vital role in new treatment methods for OS. This review presents new findings regarding the association of lncRNAs with OS and summarizes potential clinical applications of OS with lncRNAs, including the downregulation of oncogenic lncRNAs, upregulation of tumor suppressive lncRNAs, and lncRNAs-based treatment to improve chemotherapy resistance. We hope these potential methods will be translated into clinical applications and greatly reduce patient suffering.
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Affiliation(s)
- Shi Xiaotong
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Li Xiao
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Liao Shiyu
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Bi Zhiguo
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Feng Chunyang
- Department of Obstetrics and Gynecology, Renji Hospital of Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Feng Chunyang, ; Liu Jianguo,
| | - Liu Jianguo
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China,*Correspondence: Feng Chunyang, ; Liu Jianguo,
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Du L, Zhu G, Xu Y, Han B, Wang Y, Zhu M, Meng Y, Chen H, Yu Z. Integrated radiochemotherapy study of ZIF-8 coated with osteosarcoma-platelet hybrid membranes for the delivery of Dbait and Adriamycin. Front Bioeng Biotechnol 2023; 11:1147064. [PMID: 36873373 PMCID: PMC9981937 DOI: 10.3389/fbioe.2023.1147064] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/09/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction: The toxic side effects of systemic high-dose chemotherapy and poor sensitivity to radiotherapy hinder the survival rate of patients with osteosarcoma (OS). Nanotechnology offers new solutions for OS treatment; however, conventional nanocarriers suffer from inadequate targeting of tumors and short in vivo circulation time. Methods: Here, we designed a novel drug delivery system, [Dbait-ADM@ZIF-8]OPM, which uses OS-platelet hybrid membranes to encapsulate nanocarriers, to enhance the targeting and circulation time of nanocarriers, thereby enabling high enrichment of the nanocarriers in OS sites. Results: In the tumor microenvironment, the pH-sensitive nanocarrier, which is the metal-organic framework ZIF-8, dissociates to release radiosensitizer Dbait and the classical chemotherapeutic agent Adriamycin for the integrated treatment of OS via radiotherapy and chemotherapy. Benefiting from the excellent targeting ability of the hybrid membrane and the outstanding drug loading capacity of the nanocarrier, [Dbait-ADM@ZIF-8]OPM showed potent anti-tumor effects in tumor-bearing mice with almost no significant biotoxicity. Conclusion: Overall, this project is a successful exploration of the combination of radiotherapy and chemotherapy of OS treatment. Our findings solve the problems of the insensitivity of OS to radiotherapy and the toxic side effects of chemotherapy. Furthermore, this study is an expansion of the research of OS nanocarriers and provides new potential treatments for OS.
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Affiliation(s)
- Longhai Du
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, China
| | - Guanghao Zhu
- Department of Otolaryngology, Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yanlong Xu
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, China
| | - Binxu Han
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yu Wang
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, China
| | - Minhui Zhu
- Department of Otolaryngology, Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yingdi Meng
- Department of Otolaryngology, Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Huaiwen Chen
- Department of Otolaryngology, Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Zuochong Yu
- Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, China
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Basit Q, Qazi HS, Tanveer S. Osteosarcoma and Its Advancement. Cancer Treat Res 2023; 185:127-139. [PMID: 37306908 DOI: 10.1007/978-3-031-27156-4_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cancer with its high mortality rate is really hard to treat even in this era. Extensive research work is still required to overcome the threat caused by the disease. Currently, the treatment modality is based on the combination therapy, and diagnostics is dependent upon biopsy results. Once the stage of cancer is clear, the treatment is prescribed. To bring a successful treatment approach of patients with osteosarcoma, it requires multidisciplinary team approach including pediatric, medical and surgical oncologist, surgeons, pathologists, pain management, orthopedic oncologist, endocrinologist, and radiologists. Therefore, cancer treatment is to be performed in specialized hospitals able to provide access to all approaches with multidisciplinary team care.
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Affiliation(s)
- Qazi Basit
- Orthopedic Sports Medicine Center, Al Mana General Hospital, Jubail, Saudi Arabia.
| | | | - Shumaila Tanveer
- FCPS General surgery, Newcross Hospital, The Royal Wolverhampton Trust, Wolverhampton, UK
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Wang J, Ni XZ, Yang ML, Huang X, Hou SM, Peng C, Cao JS, Liu TL. Prognostic factors and treatment outcomes of spinal osteosarcoma: Surveillance, epidemiology, and end results database analysis. Front Oncol 2023; 13:1083776. [PMID: 36937397 PMCID: PMC10014918 DOI: 10.3389/fonc.2023.1083776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/10/2023] [Indexed: 03/05/2023] Open
Abstract
Objective Spinal osteosarcoma is a rare osseous neoplasm. The aim of this study is to make a comprehensive analysis of the demographic features, clinicopathologic characteristics and factors affecting prognosis of spinal osteosarcoma using the Surveillance, Epidemiology and End Results (SEER) database. Methods SEER data were reviewed to identify patients diagnosed with spinal osteosarcoma between 1975 and 2016 and determine their overall survival (OS) and disease-specifc survival (DSS). Univariate and multivariate analyses were performed using the Cox-regression proportional hazards model and Kaplan-Meier method. Results A total of 668 patients (53.1% males) with spinal osteosarcoma were identified. The mean age at diagnosis was 45.2 years, including 67.5% patients younger than 60 years. The median OS of these patients was 15 months, and the 5-year OS was 16.8%. Multivariate analysis showed that age ≥60 year (HR=2.271, p = 0.008), high grade (HR=1.323, p = 0.008), regional stage (HR=1.658, p = 0.017), metastasis stage (HR=3.045, p < 0.001) and no-surgery treatment (HR=1.761, p < 0.001) were adversely associated with OS; gender (HR=0.657, p = 0.044), tumor grade (HR=1.616, p = 0.006), tumor stage (HR=3.329, p = 0.011; HR=7.983, p < 0.001) and radiotherapy (HR=0.606, p = 0.031) were independent prognostic factors affecting DSS. Conclusion Based on SEER data analysis, male, high tumor grade, regional stage, metastasis stage and radiotherapy are independent predictors of poor survival of patients with spinal osteosarcoma. The clinical treatment of spinal osteosarcoma still faces serious challenges. Future research should focus on the clinical impact and survival outcomes of the emerging targeted and immune therapies for the sake of improving the survival stalemate of spinal osteosarcoma.
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11
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Zhang S, Wu Y, Yu J, Ma C, Wang Y, Wang Y, Li L, Zhang LW. Gadolinium-Bisphosphonate Nanoparticle-Based Low-Dose Radioimmunotherapy for Osteosarcoma. ACS Biomater Sci Eng 2022; 8:5329-5337. [PMID: 36383732 DOI: 10.1021/acsbiomaterials.2c00880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Osteosarcoma is a malignant osteogenic tumor with a high metastatic rate commonly occurring in adolescents. Although radiotherapy is applied to treat unresectable osteosarcoma with radiation resistance, a high dose of radiotherapy is required, which may weaken the immune microenvironment. Therefore, there is an urgent need to develop novel agents to maximize the radiotherapeutic effects by eliciting immune activation effects. In this study, we synthesized therapeutic gadolinium-based metal-bisphosphonate nanoparticles (NPs) for osteosarcoma treatment that can be combined with radiotherapy. The gadolinium ion (Gd) was chelated with zoledronic acid (Zol), a commonly used drug to prevent/treat osteoporosis or bone metastases from advanced cancers, and stabilized by ovalbumin (OVA) to produce OVA-GdZol NPs. OVA-GdZol NPs were internalized into K7M2 osteosarcoma cells, showing a high sensitization effect under X-ray irradiation. Cell pretreatment of OVA-GdZol NPs significantly enhanced the radiation therapeutic effect in vitro by reducing the cell colonies and increased the signal of γH2AX-positive cells. More importantly, OVA-GdZol NPs promoted the maturation of bone marrow-derived dendritic cells (BMDCs) and M1 polarization of macrophages. The inhibitory effect on K7M2 osteosarcoma of OVA-GdZol NPs and X-ray radiation was evident, indicated by a significantly reduced tumor volume, high survival rate, and decreased lung metastasis. Meanwhile, both innate and adaptive immune systems were activated to exert a strong antitumor effect. The above results highly suggest that OVA-GdZol NPs serve as both radiosensitizers and immune adjuvants, suitable for the sequential combination of vaccination and radiotherapy.
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Affiliation(s)
- Shaodian Zhang
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, P. R. China.,The Second Affiliated Hospital of Soochow University, Suzhou 215123, China
| | - Yanxian Wu
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, P. R. China
| | - Jiangkun Yu
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, P. R. China
| | - Chunjie Ma
- The Second Affiliated Hospital of Soochow University, Suzhou 215123, China
| | - Yangyun Wang
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, P. R. China
| | - Yong Wang
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, P. R. China
| | - Liubing Li
- The Second Affiliated Hospital of Soochow University, Suzhou 215123, China
| | - Leshuai W Zhang
- School of Radiation Medicine and Protection, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, P. R. China
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12
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Song J, Yuan X, Piao L, Wang J, Wang P, Zhuang M, Liu J, Liu Z. Cellular functions and molecular mechanisms of ubiquitination in osteosarcoma. Front Oncol 2022; 12:1072701. [DOI: 10.3389/fonc.2022.1072701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
Although some advances have been made in the treatment of osteosarcoma in recent years, surgical resection remains the mainstream treatment. Initial and early diagnosis of osteosarcoma could be very difficult to achieve due to the insufficient sensitivity for the means of examination. The distal metastasis of osteosarcoma also predicts the poor prognosis of osteosarcoma. In order to solve this series of problems, people begin to discover a new method of diagnosing and treating osteosarcoma. Ubiquitination, as an emerging posttranslational modification, has been shown to be closely related to osteosarcoma in studies over the past decades. In general, this review describes the cellular functions and molecular mechanisms of ubiquitination during the development of osteosarcoma.
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13
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Tornes AJK, Stenberg VY, Larsen RH, Bruland ØS, Revheim ME, Juzeniene A. Targeted alpha therapy with the 224Ra/ 212Pb-TCMC-TP-3 dual alpha solution in a multicellular tumor spheroid model of osteosarcoma. Front Med (Lausanne) 2022; 9:1058863. [PMID: 36507500 PMCID: PMC9727293 DOI: 10.3389/fmed.2022.1058863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
Abstract
Osteosarcoma patients with overt metastases at primary diagnosis have a 5-year survival rate of less than 20%. TP-3 is a murine IgG2b monoclonal antibody with high affinity for an epitope residing on the p80 osteosarcoma cell surface membrane antigen. The tumor-associated antigen p80 is overexpressed in osteosarcomas, and has very low normal tissue expression. We propose a novel dual alpha targeting solution containing two radionuclides from the same decay chain, including the bone-seeking 224Ra, and cancer cell-surface seeking 212Pb-TCMC-TP-3 for the treatment of osteoblastic bone cancers, circulating cancer cells and micrometastases. In this in vitro study, the cytotoxic effects of 212Pb-TCMC-TP-3 (single alpha solution) and 224Ra/212Pb-TCMC-TP-3 (dual alpha solution) were investigated in a multicellular spheroid model mimicking micrometastatic disease in osteosarcoma. OHS spheroids with diameters of 253 ± 98 μm treated with 4.5, 2.7, and 3.3 kBq/ml of 212Pb-TCMC-TP-3 for 1, 4, and 24 h, respectively, were disintegrated within 3 weeks. The 212Pb-TCMC-TP-3 induced a 7-fold delay in spheroid doubling time compared to a 28-times higher dose with the non-specific 212Pb-TCMC-rituximab. The 224Ra/212Pb-TCMC-TP-3 completely disintegrated spheroids with diameters of 218-476 μm within 3 and 2 weeks after 4 and 24 h incubation with 5 kBq/ml, respectively. Treatment with 1 kBq/ml of 224Ra/212Pb-TCMC-TP-3 for 24 h caused an 11.4-fold reduction in spheroid viability compared with unconjugated 224Ra/212Pb. The single and dual alpha solutions with TP-3 showed cytotoxicity in spheroids of clinically relevant size, which warrant further testing of the dual alpha solution using in vivo osteosarcoma models.
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Affiliation(s)
- Anna Julie Kjøl Tornes
- Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway,ArtBio AS, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway,*Correspondence: Anna Julie Kjøl Tornes,
| | - Vilde Yuli Stenberg
- Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway,ArtBio AS, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Øyvind Sverre Bruland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Mona-Elisabeth Revheim
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Asta Juzeniene
- Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway,Department of Physics, University of Oslo, Oslo, Norway
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14
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Dioscin suppresses proliferation and metastasis of osteosarcoma by inhibiting HuR/Pim1 axis via the induction of miR-16-5p level. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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15
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Gao X, Gao B, Li S. Extracellular vesicles: A new diagnostic biomarker and targeted drug in osteosarcoma. Front Immunol 2022; 13:1002742. [PMID: 36211364 PMCID: PMC9539319 DOI: 10.3389/fimmu.2022.1002742] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/12/2022] [Indexed: 11/25/2022] Open
Abstract
Osteosarcoma (OS) is a primary bone cancer that is highly prevalent among adolescents and adults below the age of 20 years. The prognostic outcome of metastatic OS or relapse is extremely poor; thus, developing new diagnostic and therapeutic strategies for treating OS is necessary. Extracellular vesicles (EVs) ranging from 30–150 nm in diameter are commonly produced in different cells and are found in various types of body fluids. EVs are rich in biologically active components like proteins, lipids, and nucleic acids. They also strongly affect pathophysiological processes by modulating the intercellular signaling pathways and the exchange of biomolecules. Many studies have found that EVs influence the occurrence, development, and metastasis of osteosarcoma. The regulation of inflammatory communication pathways by EVs affects OS and other bone-related pathological conditions, such as osteoarthritis and rheumatoid arthritis. In this study, we reviewed the latest findings related to diagnosis, prognosis prediction, and the development of treatment strategies for OS from the perspective of EVs.
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Affiliation(s)
- Xiaozhuo Gao
- Department of Pathology, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Cancer Hospital of China Medical University, Shenyang, China
| | - Bo Gao
- Department of Pathology, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Cancer Hospital of China Medical University, Shenyang, China
| | - Shenglong Li
- Department of Bone and Soft Tissue Tumor Surgery, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, Cancer Hospital of China Medical University, Shenyang, China
- *Correspondence: Shenglong Li, ;
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16
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Kazantseva L, Becerra J, Santos-Ruiz L. Traditional Medicinal Plants as a Source of Inspiration for Osteosarcoma Therapy. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27155008. [PMID: 35956961 PMCID: PMC9370649 DOI: 10.3390/molecules27155008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022]
Abstract
Osteosarcoma is one of the most common types of bone cancers among paediatric patients. Despite the advances made in surgery, chemo-, and radiotherapy, the mortality rate of metastatic osteosarcoma remains unchangeably high. The standard drug combination used to treat this bone cancer has remained the same for the last 20 years, and it produces many dangerous side effects. Through history, from ancient to modern times, nature has been a remarkable source of chemical diversity, used to alleviate human disease. The application of modern scientific technology to the study of natural products has identified many specific molecules with anti-cancer properties. This review describes the latest discovered anti-cancer compounds extracted from traditional medicinal plants, with a focus on osteosarcoma research, and on their cellular and molecular mechanisms of action. The presented compounds have proven to kill osteosarcoma cells by interfering with different pathways: apoptosis induction, stimulation of autophagy, generation of reactive oxygen species, etc. This wide variety of cellular targets confer natural products the potential to be used as chemotherapeutic drugs, and also the ability to act as sensitizers in drug combination treatments. The major hindrance for these molecules is low bioavailability. A problem that may be solved by chemical modification or nano-encapsulation.
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Affiliation(s)
- Liliya Kazantseva
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Málaga, Spain
| | - José Becerra
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Málaga, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Cell Biology, Genetics and Physiology, Universidad de Málaga, 29071 Málaga, Spain
| | - Leonor Santos-Ruiz
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Málaga, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Cell Biology, Genetics and Physiology, Universidad de Málaga, 29071 Málaga, Spain
- Correspondence:
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17
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Origin and Therapies of Osteosarcoma. Cancers (Basel) 2022; 14:cancers14143503. [PMID: 35884563 PMCID: PMC9322921 DOI: 10.3390/cancers14143503] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 01/15/2023] Open
Abstract
Simple Summary Osteosarcoma is the most common malignant bone tumor in children, with a 5-year survival rate ranging from 70% to 20% depending on the aggressiveness of the disease. The current treatments have not evolved over the past four decades due in part to the genetic complexity of the disease and its heterogeneity. This review will summarize the current knowledge of OS origin, diagnosis and therapies. Abstract Osteosarcoma (OS) is the most frequent primary bone tumor, mainly affecting children and young adults. Despite therapeutic advances, the 5-year survival rate is 70% but drastically decreases to 20–30% for poor responders to therapies or for patients with metastasis. No real evolution of the survival rates has been observed for four decades, explained by poor knowledge of the origin, difficulties related to diagnosis and the lack of targeted therapies for this pediatric tumor. This review will describe a non-exhaustive overview of osteosarcoma disease from a clinical and biological point of view, describing the origin, diagnosis and therapies.
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18
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Karaismailoglu B, Ozsahin MK, Gorgun B, Deger GU, Hız M. The risk factors for mechanical complication in endoprosthetic reconstruction of knee osteosarcoma. Knee 2021; 33:327-333. [PMID: 34741832 DOI: 10.1016/j.knee.2021.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/11/2021] [Accepted: 10/10/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The increased limb survival rates and higher functional demands have also increased the mechanical complication rates of megaprostheses. This study aimed to analyse possible risk factors which can predispose patients to mechanical complications. METHODS Patients with knee osteosarcoma referred to our clinic from 1992 to 2014 were investigated retrospectively. The patients who underwent surgical resection and endoprosthetic reconstruction with at least 5 years of follow up were analysed. The revision of the megaprosthesis due to a mechanical complication was accepted as an endpoint. The possible risk factors, including cement usage, implant material, joint mechanism, neoadjuvant radiotherapy, and anatomical localization of the lesion, were analysed for any association with mechanical complication rates. RESULTS A total of 118 patients were included for final analysis. The average age was 24.5 years (standard deviation ±10.1, range: 15-64). Mechanical complication rate was 22% which included 19 aseptic loosenings and seven implant failures. The average time to mechanical complication was 32.5 months. Overall, 5-year implant survival was 78%. Multiple regression analysis revealed that cement usage is an independent risk factor for mechanical complication (P = 0.007). Although the 5-year implant survival was higher in rotating hinge and titanium implants compared with fixed hinge and cobalt chrome, the multiple regression model did not yield a correlation with mechanical complication rates. CONCLUSION Cemented implants showed significantly higher mechanical complication rates compared with cementless ones in this series of knee osteosarcoma patients who underwent megaprosthetic reconstruction. Hinge mechanism and implant material did not have a significant effect on mechanical complication rates.
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Affiliation(s)
- Bedri Karaismailoglu
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
| | - Mahmut Kursat Ozsahin
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | | | - Goker Utku Deger
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Murat Hız
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul, Turkey
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19
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Tobeiha M, Rajabi A, Raisi A, Mohajeri M, Yazdi SM, Davoodvandi A, Aslanbeigi F, Vaziri M, Hamblin MR, Mirzaei H. Potential of natural products in osteosarcoma treatment: Focus on molecular mechanisms. Biomed Pharmacother 2021; 144:112257. [PMID: 34688081 DOI: 10.1016/j.biopha.2021.112257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 02/07/2023] Open
Abstract
Osteosarcoma is the most frequent type of bone cancer found in children and adolescents, and commonly arises in the metaphyseal region of tubular long bones. Standard therapeutic approaches, such as surgery, chemotherapy, and radiation therapy, are used in the management of osteosarcoma. In recent years, the mortality rate of osteosarcoma has decreased due to advances in treatment methods. Today, the scientific community is investigating the use of different naturally derived active principles against various types of cancer. Natural bioactive compounds can function against cancer cells in two ways. Firstly they can act as classical cytotoxic compounds by non-specifically affecting macromolecules, such as DNA, enzymes, and microtubules, which are also expressed in normal proliferating cells, but to a greater extent by cancer cells. Secondly, they can act against oncogenic signal transduction pathways, many of which are activated in cancer cells. Some bioactive plant-derived agents are gaining increasing attention because of their anti-cancer properties. Moreover, some naturally-derived compounds can significantly promote the effectiveness of standard chemotherapy drugs, and in certain cases are able to ameliorate drug-induced adverse effects caused by chemotherapy. In the present review we summarize the effects of various naturally-occurring bioactive compounds against osteosarcoma.
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Affiliation(s)
- Mohammad Tobeiha
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali Rajabi
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Arash Raisi
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahshad Mohajeri
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Amirhossein Davoodvandi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran; Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Fatemeh Aslanbeigi
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - MohamadSadegh Vaziri
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa.
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
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20
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Meier B, Volkova NV, Wang B, González-Huici V, Bertolini S, Campbell PJ, Gerstung M, Gartner A. C. elegans genome-wide analysis reveals DNA repair pathways that act cooperatively to preserve genome integrity upon ionizing radiation. PLoS One 2021; 16:e0258269. [PMID: 34614038 PMCID: PMC8494335 DOI: 10.1371/journal.pone.0258269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/22/2021] [Indexed: 11/22/2022] Open
Abstract
Ionizing radiation (IR) is widely used in cancer therapy and accidental or environmental exposure is a major concern. However, little is known about the genome-wide effects IR exerts on germ cells and the relative contribution of DNA repair pathways for mending IR-induced lesions. Here, using C. elegans as a model system and using primary sequencing data from our recent high-level overview of the mutagenic consequences of 11 genotoxic agents, we investigate in detail the genome-wide mutagenic consequences of exposing wild-type and 43 DNA repair and damage response defective C. elegans strains to a Caesium (Cs-137) source, emitting γ-rays. Cs-137 radiation induced single nucleotide variants (SNVs) at a rate of ~1 base substitution per 3 Gy, affecting all nucleotides equally. In nucleotide excision repair mutants, this frequency increased 2-fold concurrently with increased dinucleotide substitutions. As observed for DNA damage induced by bulky DNA adducts, small deletions were increased in translesion polymerase mutants, while base changes decreased. Structural variants (SVs) were augmented with dose, but did not arise with significantly higher frequency in any DNA repair mutants tested. Moreover, 6% of all mutations occurred in clusters, but clustering was not significantly altered in any DNA repair mutant background. Our data is relevant for better understanding how DNA repair pathways modulate IR-induced lesions.
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Affiliation(s)
- Bettina Meier
- Centre for Gene Regulation and Expression, University of Dundee, Dundee, United Kingdom
| | - Nadezda V. Volkova
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, United Kingdom
| | - Bin Wang
- Centre for Gene Regulation and Expression, University of Dundee, Dundee, United Kingdom
- National Engineering Research Center for Non-Food Biorefinery, Guangxi Academy of Sciences, Nanning, China
| | - Víctor González-Huici
- Centre for Gene Regulation and Expression, University of Dundee, Dundee, United Kingdom
| | - Simone Bertolini
- Centre for Gene Regulation and Expression, University of Dundee, Dundee, United Kingdom
| | - Peter J. Campbell
- Cancer, Ageing and Somatic Mutation, Wellcome Sanger Institute, Hinxton, United Kingdom
- Department of Haematology, University of Cambridge, Cambridge, United Kingdom
- Department of Haematology, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Moritz Gerstung
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, United Kingdom
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Anton Gartner
- Centre for Gene Regulation and Expression, University of Dundee, Dundee, United Kingdom
- Center for Genomic Integrity, Institute for Basic Science, Ulsan, Republic of Korea
- Department of Biological Sciences, School of Life Sciences, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
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21
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Laskar S, Kakoti S, Khanna N, Manjali JJ, Mangaj A, Puri A, Gulia A, Nayak P, Pai P, Nair D, Qureshi S, Chinnaswamy G, Bajpai J, Prabhash K, Rekhi B, Ramadwar M, Jambhekar N, Janu A, Juvekar S, Purandare N, Rangarajan V. Outcomes of osteosarcoma, chondrosarcoma and chordoma treated with image guided-intensity modulated radiation therapy. Radiother Oncol 2021; 164:216-222. [PMID: 34597737 DOI: 10.1016/j.radonc.2021.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND & PURPOSE To evaluate the efficacy and toxicity of dose-escalated image guided-intensity modulated radiation therapy (IG-IMRT) in osteosarcoma (OGS), chondrosarcoma (CS) and chordoma (CH) of head and neck (H&N) and pelvis. METHODS AND MATERIALS In this prospective non-randomized study, 65 patients of H&N or pelvic OGS (24), CS (7) and CH (34) mandating definitive or post-operative radiotherapy from May 2013 to December 2018 were included. Radiotherapy doses in definitive setting were 72.0 Gy for CH and 70.2 Gy for OGS and CS; while in post-operative setting it was 66.6 Gy and 64.8 Gy respectively (at 1.8 Gy per fraction). RESULTS Planned doses of radiotherapy could be completed in 61 (93.8%) patients; with grade III or higher acute and late toxicities of 3% and 0% respectively. With a median follow-up of 52 (range 6-92) months, the five-year actuarial local control (LC) rates were 66% in OGS, 38.1% in CS and 75.9% in CH; while cause-specific survival (CSS) rates were 54.7%, 64.3% and 92.2% respectively. There was no statistically significant difference in outcomes for patients receiving definitive and post-operative radiotherapy. Locally controlled disease at first follow-up after radiotherapy was associated with improved CSS and OS in CS (p = 0.014) and CH (p < 0.001). Radiotherapy resulted in significant and sustained improvement in Musculoskeletal tumour society (MSTS) score and reduction in pain score. Salvage re-irradiation was feasible in local progression after radiotherapy, with good outcomes and tolerability. CONCLUSION Dose-escalated IG-IMRT results in good LC & functional improvement with minimal toxicity in OGS, CS and CH.
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Affiliation(s)
- Siddhartha Laskar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India.
| | - Sangeeta Kakoti
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Nehal Khanna
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Jifmi Jose Manjali
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Akshay Mangaj
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ajay Puri
- Department of Orthopedic Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ashish Gulia
- Department of Orthopedic Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Prakash Nayak
- Department of Orthopedic Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Prathamesh Pai
- Department of Head & Neck Surgery, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Deepa Nair
- Department of Head & Neck Surgery, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sajid Qureshi
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Girish Chinnaswamy
- Department of Paediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Bharat Rekhi
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Mukta Ramadwar
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Nirmala Jambhekar
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Amit Janu
- Department of Radiodiagnosis, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sashikant Juvekar
- Department of Radiodiagnosis, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Nilendu Purandare
- Department of Nuclear Medicine & Molecular Imaging, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine & Molecular Imaging, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
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22
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Zhang W, Zhao W, Li Q, Zhao D, Qu J, Yuan Z, Cheng Z, Zhu X, Zhuang X, Zhang Z. 3D-printing magnesium-polycaprolactone loaded with melatonin inhibits the development of osteosarcoma by regulating cell-in-cell structures. J Nanobiotechnology 2021; 19:263. [PMID: 34481503 PMCID: PMC8418751 DOI: 10.1186/s12951-021-01012-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 12/30/2022] Open
Abstract
Melatonin has been proposed as a potent anticarcinogen presents a short half-life for osteosarcoma (OS). Cell-in-cell (CIC) structures play a role in the development of malignant tumors by changing the tumor cell energy metabolism. This study developed a melatonin-loaded 3D printed magnesium-polycaprolactone (Mg-PCL) scaffold and investigated its effect and molecular mechanism on CIC in OS. Mg-PCL scaffold was prepared by 3D-printing and its characteristic was determined. The effect and molecular mechanism of Mg-PCL scaffold as well as melatonin-loaded Mg-PCL on OS growth and progression were investigated in vivo and in vitro. We found that melatonin receptor 1 (MT1) and CIC expressions were increased in OS tissues and cells. Melatonin treatment inhibit the key CIC pathway, Rho/ROCK, through the cAMP/PKA signaling pathway, interfering with the mitochondrial physiology of OS cells, and thus playing an anti-invasion and anti-metastasis role in OS. The Mg-PCL-MT could significantly inhibit distant organ metastasis of OS in the in vivo model. Our results showed that melatonin-loaded Mg-PCL scaffolds inhibited the proliferation, invasion and metastasis of OS cells through the CIC pathway. The Mg-PCL-MT could be a potential therapeutics for OS.
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Affiliation(s)
- Weilin Zhang
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, Liaoning, China
| | - Wei Zhao
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, Liaoning, China
| | - Qin Li
- Translational Medicine Center, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Duoyi Zhao
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, Liaoning, China
| | - Junxing Qu
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, Liaoning, China
| | - Ziyang Yuan
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, Liaoning, China
| | - Zhihong Cheng
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, Liaoning, China
| | - Xiaojuan Zhu
- Key Laboratory of Molecular Epigenetics, Ministry of Education and Institute of Cytology and Genetics, Northeast Normal University, Changchun, Jilin, China
| | - Xiuli Zhuang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry Chinese Academy of Sciences, Changchun, Jilin, China
| | - Zhiyu Zhang
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, Liaoning, China.
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Bordbar M, Sarfaraz A, Haghpanah S, Zekavat O, Zareifar S, Zarei T. The Outcome of Children With Malignant Bone Tumors: A Single-Center Experience. Glob Pediatr Health 2021; 8:2333794X211042238. [PMID: 34471652 PMCID: PMC8404661 DOI: 10.1177/2333794x211042238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/07/2021] [Indexed: 11/24/2022] Open
Abstract
Malignant bone tumors (MBT) account for 3% to 5% of cancers in children younger than 15 years. We aimed to report the outcome of children with MBT in 10 years in Southern Iran. During the study period, 100 patients (57 Osteosarcoma, 43 Ewing sarcoma) with an M/F ratio of 1.56 and a median age of 13.8 years (3.8-17.9) were diagnosed. Metastasis occurred in 27% of patients, mostly in the first 3 months of diagnosis. The mean survival time of MBT altogether was 94.1 months (95% CI: 86.5-101.7). The 5-year overall survival and event-free survivals were 85.2% (95% CI: 74%-91.8%) and 69.2% (95% CI: 56%-79%), respectively. Metastasis was the only independent risk factor of death in our study cohort (Hazard ratio 36.7, 95% CI: 4.8-282.6, P = .001) MBT in children mostly occur in adolescent boys. About one-third of them become metastatic, which is significantly associated with poor outcomes.
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Affiliation(s)
| | - Ali Sarfaraz
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omidreza Zekavat
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheila Zareifar
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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24
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Ha TW, Park S, Youn MY, Kim DW, Kim HJ. Carbon-ion radiotherapy in osteosarcoma of the mandible: a case report. J Korean Assoc Oral Maxillofac Surg 2021; 47:315-320. [PMID: 34462388 PMCID: PMC8408645 DOI: 10.5125/jkaoms.2021.47.4.315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/11/2019] [Accepted: 10/15/2019] [Indexed: 02/03/2023] Open
Abstract
Carbon-ion radiotherapy (CIRT) is on the rise as a treatment choice for malignant tumor. Compared to conventional radiotherapy, particle beams have different physical and biological properties. Particle beam provides a low entry dose, deposits most of the energy at the endpoint of the flight path, and forms an asymptotic dose peak (the "Bragg peak"). Compared to protons, carbon with its larger mass decreases beam scattering, resulting in a sharper dose distribution border. We report a 50-year-old male who underwent CIRT without surgical resection on osteosarcoma of the mandible. After CIRT, the patient's pain was gone, and the malignant mass remained stable with accompanying necrosis. Nine months later, however, magnetic resonance imaging demonstrated progression of the left mandibular osteosarcoma with pulmonary metastases. After multidisciplinary discussion, concurrent chemoradiotherapy was conducted. While necrotic bone segments came out of the mandible during subsequent periodic outpatient visits, the tumor itself was stable. Thirty months after his first visit and diagnosis, the patient is waiting for chemotherapy. Although CIRT is superior in treating radioresistant hypoxic disease, CIRT is in its infancy, so care must be taken for its indications and complications.
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Affiliation(s)
- Tae-Wook Ha
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Slmaro Park
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Min Yeong Youn
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Dong Wook Kim
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyung Jun Kim
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
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25
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Investigating Optimal Chemotherapy Options for Osteosarcoma Patients through a Mathematical Model. Cells 2021; 10:cells10082009. [PMID: 34440778 PMCID: PMC8394778 DOI: 10.3390/cells10082009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 12/22/2022] Open
Abstract
Simple Summary Osteosarcoma is a rare type of cancer with poor prognoses. However, to the best of our knowledge, there are no mathematical models that study the impact of chemotherapy treatments on the osteosarcoma microenvironment. In this study, we developed a data driven mathematical model to analyze the dynamics of the important players in three groups of osteosarcoma tumors with distinct immune patterns in the presence of the most common chemotherapy drugs. The results indicate that the treatments’ start times and optimal dosages depend on the unique growth rate of the tumor, which implies the necessity of personalized medicine. Furthermore, the developed model can be extended by others to build models that can recommend individual-specific optimal dosages. Abstract Since all tumors are unique, they may respond differently to the same treatments. Therefore, it is necessary to study their characteristics individually to find their best treatment options. We built a mathematical model for the interactions between the most common chemotherapy drugs and the osteosarcoma microenvironments of three clusters of tumors with unique immune profiles. We then investigated the effects of chemotherapy with different treatment regimens and various treatment start times on the behaviors of immune and cancer cells in each cluster. Saliently, we suggest the optimal drug dosages for the tumors in each cluster. The results show that abundances of dendritic cells and HMGB1 increase when drugs are given and decrease when drugs are absent. Populations of helper T cells, cytotoxic cells, and IFN-γ grow, and populations of cancer cells and other immune cells shrink during treatment. According to the model, the MAP regimen does a good job at killing cancer, and is more effective than doxorubicin and cisplatin combined or methotrexate alone. The results also indicate that it is important to consider the tumor’s unique growth rate when deciding the treatment details, as fast growing tumors need early treatment start times and high dosages.
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26
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Eker N, Tokuc AG, Yılmaz B, Aktaş Z, Buğdaycı O, Erol B, Senay E, Aras S. Outcomes of Osteosarcoma in Children Without High-Dose Methotrexate: Could It Be Less Toxic Without Effecting Survival Rates? J Adolesc Young Adult Oncol 2021; 11:252-258. [PMID: 34342492 DOI: 10.1089/jayao.2021.0075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background: Osteosarcoma (OS) is the most common primary bone sarcoma in childhood. High-dose methotrexate, doxorubicine, cisplatin, and/or ifosfamide combinations are used as standard treatment in chemotherapy and could cause serious toxicity. Another alternative chemotherapy protocol is consisting of epirubicin, ifosfamide, and cisplatin (ECI), which we use in our center. The aim of this study was to evaluate the patients with OS who were treated with ECI protocol, retrospectively. Methods: Forty-three patients with OS diagnosed at our center between December 1995 and September 2017 were evaluated retrospectively. Results: The mean follow-up period was 31 months (5-145 months). Recurrence was detected in 15 of 43 patients. When the factors affecting relapse are examined, recurrence was higher in patients who were older than 10 years at the time of diagnosis, upper extremity involvement, osteoblastic, and chondroblastic subgroups, but there was no statistically significant difference. Five-year and 10-year overall survival rates were 67.4% and 58.9%, and event-free survival rates were 54% and 47.3%, respectively. While 5-year overall survival rate was 86.7% in nonrecurrent cases, this rate was 40.9% in recurrent cases and this difference was statistically significant (p = 0.023). Just two patients died because of the toxicity. Conclusion: The prognosis of OS is still poor in relapse cases, so the choice of chemotherapy for neoadjuvant and adjuvant therapy is vital. When the risk of toxicity is also considered, the first step of ECI protocol is seen as a preferable treatment option because the survival rates are similar to the literature.
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Affiliation(s)
- Nurşah Eker
- Department of Pediatric Hematology Oncology, Marmara University, Marmara Faculty of Medicine, Istanbul, Turkey
| | - Ayşe G Tokuc
- Department of Pediatric Hematology Oncology, Marmara University, Marmara Faculty of Medicine, Istanbul, Turkey
| | - Barış Yılmaz
- Department of Pediatric Hematology Oncology, Marmara University, Pendik Education and Research Hospital, Istanbul, Turkey
| | - Zeynep Aktaş
- Department of Public Health, Marmara University, Marmara Faculty of Medicine, Istanbul, Turkey
| | - Onur Buğdaycı
- Department of Radiology, and Marmara University, Marmara Faculty of Medicine, Istanbul, Turkey
| | - Bülent Erol
- Department of Orthopedic Surgery, Marmara University, Marmara Faculty of Medicine, Istanbul, Turkey
| | - Emel Senay
- Department of Pediatric Hematology Oncology, Marmara University, Pendik Education and Research Hospital, Istanbul, Turkey
| | - Seda Aras
- Department of Pediatric Hematology Oncology, Marmara University, Marmara Faculty of Medicine, Istanbul, Turkey
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Polydatin Induces Differentiation and Radiation Sensitivity in Human Osteosarcoma Cells and Parallel Secretion through Lipid Metabolite Secretion. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:3337013. [PMID: 34336090 PMCID: PMC8318750 DOI: 10.1155/2021/3337013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/10/2021] [Accepted: 07/02/2021] [Indexed: 01/13/2023]
Abstract
Osteosarcoma is a bone cancer characterized by the production of osteoid tissue and immature bone from mesenchymal cells. Osteosarcoma mainly affects long bones (femur is most frequently site) and occur in children and young adults with greater incidence. Here, we investigated the role accomplished by polydatin, a natural antioxidative compound, in promoting osteogenic differentiation alone or after radiation therapy on osteosarcoma cells. In vitro, polydatin significantly induced cell cycle arrest in S-phase and enhanced bone alkaline phosphatase activity. Moreover, the differentiation process was paralleled by the activation of Wnt-β-catenin pathway. In combination with radiotherapy, the pretreatment with polydatin promoted a radiosensitizing effect on osteosarcoma cancer cells as demonstrated by the upregulation of osteogenic markers and reduced clonogenic survival of tumor cells. Additionally, we analyzed, by mass spectrometry, the secretion of sphingolipid, ceramides, and their metabolites in osteosarcoma cells treated with polydatin. Overall, our results demonstrate that polydatin, through the secretion of sphingolipids and ceramide, induced osteogenic differentiation, alone and in the presence of ionizing therapy. Future investigations are needed to validate the use of polydatin in clinical practice as a potentiating agent of radiotherapy-induced anticancer effects.
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Truong LB, Medina Cruz D, Mostafavi E, O’Connell CP, Webster TJ. Advances in 3D-Printed Surface-Modified Ca-Si Bioceramic Structures and Their Potential for Bone Tumor Therapy. MATERIALS (BASEL, SWITZERLAND) 2021; 14:3844. [PMID: 34300763 PMCID: PMC8306413 DOI: 10.3390/ma14143844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 01/02/2023]
Abstract
Bioceramics such as calcium silicate (Ca-Si), have gained a lot of interest in the biomedical field due to their strength, osteogenesis capability, mechanical stability, and biocompatibility. As such, these materials are excellent candidates to promote bone and tissue regeneration along with treating bone cancer. Bioceramic scaffolds, functionalized with appropriate materials, can achieve desirable photothermal effects, opening up a bifunctional approach to osteosarcoma treatments-simultaneously killing cancerous cells while expediting healthy bone tissue regeneration. At the same time, they can also be used as vehicles and cargo structures to deliver anticancer drugs and molecules in a targeted manner to tumorous tissue. However, the traditional synthesis routes for these bioceramic scaffolds limit the macro-, micro-, and nanostructures necessary for maximal benefits for photothermal therapy and drug delivery. Therefore, a different approach to formulate bioceramic scaffolds has emerged in the form of 3D printing, which offers a sustainable, highly reproducible, and scalable method for the production of valuable biomedical materials. Here, calcium silicate (Ca-Si) is reviewed as a novel 3D printing base material, functionalized with highly photothermal materials for osteosarcoma therapy and drug delivery platforms. Consequently, this review aims to detail advances made towards functionalizing 3D-printed Ca-Si and similar bioceramic scaffold structures as well as their resulting applications for various aspects of tumor therapy, with a focus on the external surface and internal dispersion functionalization of the scaffolds.
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Affiliation(s)
- Linh B. Truong
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115, USA; (L.B.T.); (D.M.C.); (C.P.O.); (T.J.W.)
| | - David Medina Cruz
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115, USA; (L.B.T.); (D.M.C.); (C.P.O.); (T.J.W.)
| | - Ebrahim Mostafavi
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115, USA; (L.B.T.); (D.M.C.); (C.P.O.); (T.J.W.)
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Catherine P. O’Connell
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115, USA; (L.B.T.); (D.M.C.); (C.P.O.); (T.J.W.)
| | - Thomas J. Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115, USA; (L.B.T.); (D.M.C.); (C.P.O.); (T.J.W.)
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29
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Hız M, Karaismailoglu B, Ulutas S, Camurdan VB, Gorgun B, Oner Dincbas F. The effect of preoperative radiotherapy on local control and prognosis in high-grade non-metastatic intramedullary osteosarcoma of the extremities. Arch Orthop Trauma Surg 2021; 141:1083-1089. [PMID: 32506177 DOI: 10.1007/s00402-020-03494-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/31/2020] [Indexed: 01/25/2023]
Abstract
INTRODUCTION This study aimed to analyse the effect of preoperative radiotherapy on survival, recurrence and necrosis rates in osteosarcoma patients treated with neoadjuvant chemotherapy and limb-salvage surgery. MATERIALS AND METHODS Osteosarcoma patients who referred to our clinic from 1998 to 2015 were investigated retrospectively. 141 patients with non-metastatic osteosarcoma of the limb who received neoadjuvant chemotherapy and underwent limb-sparing surgery with or without preoperative radiotherapy were included in the study. 73 patients had neoadjuvant chemotherapy only (CT group), while 68 patients had additional preoperative radiotherapy (CT + RT group). 5-year survival, disease-free survival, limb survival, local recurrence, metastasis, complication and necrosis rates were compared between the two groups. RESULTS Overall 5-year survival, 5-year disease-free survival, 5-year limb survival rates were 68.5, 64.3, 65.7 for CT group and 72.1, 67.6, 64.7 for CT + RT group, respectively. Preoperative radiotherapy gave similar survival and disease-free survival rates. Limb survival, recurrence and metastasis rates were similar between the groups. The necrosis rate of the lesions was significantly higher in the CT + RT group compared to the CT group. CONCLUSION Preoperative radiotherapy can provide a higher necrosis rate and may allow the resection of unresectable lesions in the treatment of osteosarcoma. CT + RT provided similar 5-year survival despite the larger tumour size compared to CT group. Due to the higher wound complication rate (8.2% in CT, 23.5% in CT + RT group, p = 0.01), CT + RT should be restricted to the lesions with large size or close proximity to neurovascular structures. LEVEL OF EVIDENCE Level III; Therapeutic, Retrospective comparative study.
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Affiliation(s)
- Murat Hız
- Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul University-Cerrahpasa, Istanbul, 34093, Turkey
| | - Bedri Karaismailoglu
- Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul University-Cerrahpasa, Istanbul, 34093, Turkey.
| | - Suat Ulutas
- Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul University-Cerrahpasa, Istanbul, 34093, Turkey
| | - Vedat Burkay Camurdan
- Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul University-Cerrahpasa, Istanbul, 34093, Turkey
| | | | - Fazilet Oner Dincbas
- Cerrahpasa Medical Faculty, Department of Radiation Oncology, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Tung FI, Chen LC, Wang YC, Chen MH, Shueng PW, Liu TY. Using a Hybrid Radioenhancer to Discover Tumor Cell-targeted Treatment for Osteosarcoma: An In Vitro Study. Curr Med Chem 2021; 28:3877-3889. [PMID: 33213306 DOI: 10.2174/0929867327666201118155216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 11/22/2022]
Abstract
Osteosarcoma is insensitive to radiation. High-dose radiation is often used as a treatment but causes side effects in patients. Hence, it is important to develop tumor cell-- targeted radiotherapy that could improve radiotherapy efficiency on tumor cells and reduce the toxic effect on normal cells during radiation treatment. In this study, we developed an innovative method for treating osteosarcoma by using a novel radiation-enhancer (i.e., carboxymethyl-hexanoyl chitosan-coated self-assembled Au@Fe3O4 nanoparticles; CSAF NPs). CSAF NPs were employed together with 5-aminolevulinic acid (5- ALA) to achieve tumor cell-targeted radiotherapy. In this study, osteosarcoma cells (MG63) and normal cells (MC3T3-E1) were used for an in vitro investigation, in which reactive oxygen species (ROS) assay, cell viability assay, clonogenic assay, and western blot were used to confirm the treatment efficiency. The ROS assay showed that the combination of CSAF NPs and 5-ALA enhanced radiation-induced ROS production in tumor cells (MG63); however, this was not observed in normal cells (MC3T3-E1). The cell viability ratio of normal cells to tumor cells after treatment with CSAF NPs and 5-ALA reached 2.79. Moreover, the clonogenic assay showed that the radiosensitivity of MG63 cells was increased by the combination use of CSAF NPs and 5-ALA. This was supported by performing a western blot that confirmed the expression of cytochrome c (a marker of cell mitochondria damage) and caspase-3 (a marker of cell apoptosis). The results provide an essential basis for developing tumor-cell targeted radiotherapy by means of low-- dose radiation.
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Affiliation(s)
- Fu-I Tung
- Department of Orthopaedic Surgery, Taipei City Hospital, Taipei, Taiwan, China
| | - Li-Chin Chen
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan, China
| | - Yu-Chi Wang
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan, China
| | - Ming-Hong Chen
- Department of Neurosurgery, Taipei Municipal Wanfang Hospital, Taipei, Taiwan, China
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, China
| | - Tse-Ying Liu
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan, China
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Tong CJ, Deng QC, Ou DJ, Long X, Liu H, Huang K. LncRNA RUSC1-AS1 promotes osteosarcoma progression through regulating the miR-340-5p and PI3K/AKT pathway. Aging (Albany NY) 2021; 13:20116-20130. [PMID: 34048366 PMCID: PMC8436931 DOI: 10.18632/aging.203047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/02/2021] [Indexed: 11/25/2022]
Abstract
Dysregulation of long noncoding RNA (lncRNA) is frequently involved in the progression and development of osteosarcoma. LncRNA RUSC1-AS1 is reported to be upregulated and acts as an oncogene in hepatocellular carcinoma, cervical cancer and breast cancer. However, its role in osteosarcoma has not been studied yet. In the present study, we investigated the role of RUSC1-AS1 in osteosarcoma both in vitro and in vivo. The results showed that the expression of RUSC1-AS1 was significantly upregulated in osteosarcoma cell line U2OS and HOS compared to that in human osteoblast cell line hFOB1.19. Similar results were found in human samples. Silencing RUSC1-AS1 by siRNA significantly inhibited U2OS and HOS cell proliferation and invasion, measured by CCK-8 and transwell assay. Besides, knockdown of RUSC1-AS1 increased cell apoptosis in osteosarcoma cell lines. In addition, RUSC1-AS1 promoted the epithelial-mesenchymal transition (EMT) process of osteosarcoma cells. In vivo experiments confirmed that RUSC1-AS1 knockdown had an inhibitory effect on osteosarcoma tumor growth. Mechanically, we showed that RUSC1-AS1 directly binds to and inhibits miR-340-5p and activates the PI3K/AKT signaling pathway. In conclusion, our study demonstrated that RUSC1-AS1 promoted osteosarcoma development both in vitro and in vivo through sponging to miR-340-5p and activating the PI3K/AKT signaling pathway. Therefore, RUSC1-AS1 becomes a potential therapeutic target for osteosarcoma.
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Affiliation(s)
- Chang-Jun Tong
- Department of Orthopedics, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, China
| | - Qing-Chun Deng
- Department of Gynecology, The Second Affiliated Hospital of Hainan Medical University, Haikou 570102, China
| | - Di-Jun Ou
- Department of Orthopedics, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, China
| | - Xia Long
- Department of Operating Room, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, China
| | - He Liu
- Department of Orthopedics, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, China
| | - Kang Huang
- Department of Orthopedics, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, China
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Le T, Su S, Kirshtein A, Shahriyari L. Data-Driven Mathematical Model of Osteosarcoma. Cancers (Basel) 2021; 13:cancers13102367. [PMID: 34068946 PMCID: PMC8156666 DOI: 10.3390/cancers13102367] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 12/22/2022] Open
Abstract
As the immune system has a significant role in tumor progression, in this paper, we develop a data-driven mathematical model to study the interactions between immune cells and the osteosarcoma microenvironment. Osteosarcoma tumors are divided into three clusters based on their relative abundance of immune cells as estimated from their gene expression profiles. We then analyze the tumor progression and effects of the immune system on cancer growth in each cluster. Cluster 3, which had approximately the same number of naive and M2 macrophages, had the slowest tumor growth, and cluster 2, with the highest population of naive macrophages, had the highest cancer population at the steady states. We also found that the fastest growth of cancer occurred when the anti-tumor immune cells and cytokines, including dendritic cells, helper T cells, cytotoxic cells, and IFN-γ, switched from increasing to decreasing, while the dynamics of regulatory T cells switched from decreasing to increasing. Importantly, the most impactful immune parameters on the number of cancer and total cells were the activation and decay rates of the macrophages and regulatory T cells for all clusters. This work presents the first osteosarcoma progression model, which can be later extended to investigate the effectiveness of various osteosarcoma treatments.
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Affiliation(s)
- Trang Le
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA 01003, USA; (T.L.); (S.S.)
| | - Sumeyye Su
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA 01003, USA; (T.L.); (S.S.)
| | - Arkadz Kirshtein
- Department of Mathematics, Tufts University, Medford, MA 02155, USA;
| | - Leili Shahriyari
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA 01003, USA; (T.L.); (S.S.)
- Correspondence:
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Eaton BR, Schwarz R, Vatner R, Yeh B, Claude L, Indelicato DJ, Laack N. Osteosarcoma. Pediatr Blood Cancer 2021; 68 Suppl 2:e28352. [PMID: 32779875 DOI: 10.1002/pbc.28352] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 12/19/2022]
Abstract
Osteosarcoma is a rare tumor that requires complex multidisciplinary management. This paper reviews the general management and standard radiotherapy guidelines for osteosarcoma in both North America and Europe in a joined effort between the Children's Oncology Group and International Society of Pediatric Oncology. Standard treatment involves multiagent induction chemotherapy followed by surgical resection for local tumor control and consolidation local control to metastatic sites. Radiotherapy is reserved for cases with a marginal or incomplete resection or for definitive treatment in the case of unresectable disease. We present supporting data for the role of chemotherapy, surgery, and radiation therapy.
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Affiliation(s)
- Bree R Eaton
- Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Rudolf Schwarz
- Radiotherapy and Radiooncology, Outpatient Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralph Vatner
- Radiation Oncology, University of Cincinnati, Cincinnati, Ohio
| | - Brian Yeh
- Radiation Oncology, Mount Sinai Hospital, New York, New York
| | - Line Claude
- Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Daniel J Indelicato
- Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida
| | - Nadia Laack
- Radiation Oncology, Mayo Clinic, Rochester, Minnesota
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Spałek MJ, Poleszczuk J, Czarnecka AM, Dudzisz-Śledź M, Napieralska A, Matysiakiewicz J, Chojnacka M, Raciborska A, Sztuder A, Maciejczyk A, Szulc A, Skóra T, Cybulska-Stopa B, Winiecki T, Kaźmierska J, Tomasik B, Fijuth J, Rutkowski P. Radiotherapy in the Management of Pediatric and Adult Osteosarcomas: A Multi-Institutional Cohort Analysis. Cells 2021; 10:cells10020366. [PMID: 33578676 PMCID: PMC7916348 DOI: 10.3390/cells10020366] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/31/2021] [Accepted: 02/07/2021] [Indexed: 02/06/2023] Open
Abstract
Background: Due to the rarity of osteosarcoma and limited indications for radiotherapy (RT), data on RT for this tumor are scarce. This study aimed to investigate the utilization of RT for osteosarcomas in the recent 20 years and to identify factors related to patients’ response to radiation. Methods: We performed a retrospective analysis of patients irradiated for osteosarcoma treatment. We planned to assess differences in the utilization of RT between the periods of 2000–2010 and 2011–2020, identify the risk factors associated with local progression (LP), determine whether RT-related parameters are associated with LP, and calculate patients’ survival. Results: A total of 126 patients with osteosarcoma who received 181 RT treatments were identified. We found a difference in RT techniques between RT performed in the years 2000–2010 and that performed in the years 2011–2020. LP was observed after 37 (20.4%) RT treatments. Intent of RT, distant metastases, and concomitant systemic treatment affected the risk of LP. Five-year overall survival was 33% (95% confidence interval (26%–43%)). Conclusions: RT for osteosarcoma treatment has evolved from simple two-dimensional palliative irradiation into more conformal RT applied for new indications including oligometastatic and oligoprogressive disease. RT may be a valuable treatment modality for selected patients with osteosarcoma.
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Affiliation(s)
- Mateusz Jacek Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.C.); (M.D.-Ś.); (P.R.)
- Correspondence: ; Tel.: +48-22-546-24-55
| | - Jan Poleszczuk
- Department for Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-034 Warsaw, Poland;
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 02-109 Warsaw, Poland
| | - Anna Małgorzata Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.C.); (M.D.-Ś.); (P.R.)
- Mossakowski Medical Research Centre, Department of Experimental Pharmacology, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Monika Dudzisz-Śledź
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.C.); (M.D.-Ś.); (P.R.)
| | - Aleksandra Napieralska
- Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | - Jacek Matysiakiewicz
- Trauma and Orthopedic Surgery Department, IXth Ward of the District Hospital of Orthopedics and Trauma Surgery in Piekary Slaskie, 41-940 Piekary Slaskie, Poland;
| | - Marzanna Chojnacka
- Department of Oncology and Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, 02-034 Warsaw, Poland;
| | - Anna Raciborska
- Department of Oncology and Surgical Oncology for Children and Youth, Institute of Mother and Child, 01-211 Warsaw, Poland;
| | - Aleksandra Sztuder
- Department of Radiotherapy, Lower Silesian Oncology Centre, 53-413 Wroclaw, Poland; (A.S.); (A.M.); (A.S.)
| | - Adam Maciejczyk
- Department of Radiotherapy, Lower Silesian Oncology Centre, 53-413 Wroclaw, Poland; (A.S.); (A.M.); (A.S.)
- Department of Oncology, Faculty of Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Agata Szulc
- Department of Radiotherapy, Lower Silesian Oncology Centre, 53-413 Wroclaw, Poland; (A.S.); (A.M.); (A.S.)
| | - Tomasz Skóra
- Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków Branch, 31-115 Kraków, Poland;
| | - Bożena Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 31-115 Kraków, Poland;
| | - Tomasz Winiecki
- Radiotherapy Department II, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (T.W.); (J.K.)
| | - Joanna Kaźmierska
- Radiotherapy Department II, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (T.W.); (J.K.)
- Electroradiology Department, University of Medical Sciences, 61-701 Poznan, Poland
| | - Bartłomiej Tomasik
- Department of Radiotherapy, Medical University of Lodz, 92-215 Lodz, Poland; (B.T.); (J.F.)
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 95-513 Lodz, Poland
- Postgraduate School of Molecular Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Jacek Fijuth
- Department of Radiotherapy, Medical University of Lodz, 92-215 Lodz, Poland; (B.T.); (J.F.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.M.C.); (M.D.-Ś.); (P.R.)
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Mechanisms of Resistance to Conventional Therapies for Osteosarcoma. Cancers (Basel) 2021; 13:cancers13040683. [PMID: 33567616 PMCID: PMC7915189 DOI: 10.3390/cancers13040683] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023] Open
Abstract
Osteosarcoma (OS) is the most common primary bone tumor, mainly occurring in children and adolescents. Current standard therapy includes tumor resection associated with multidrug chemotherapy. However, patient survival has not evolved for the past decades. Since the 1970s, the 5-year survival rate is around 75% for patients with localized OS but dramatically drops to 20% for bad responders to chemotherapy or patients with metastases. Resistance is one of the biological processes at the origin of therapeutic failure. Therefore, it is necessary to better understand and decipher molecular mechanisms of resistance to conventional chemotherapy in order to develop new strategies and to adapt treatments for patients, thus improving the survival rate. This review will describe most of the molecular mechanisms involved in OS chemoresistance, such as a decrease in intracellular accumulation of drugs, inactivation of drugs, improved DNA repair, modulations of signaling pathways, resistance linked to autophagy, disruption in genes expression linked to the cell cycle, or even implication of the micro-environment. We will also give an overview of potential therapeutic strategies to circumvent resistance development.
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Ngan SY, Chu J, Chander S. The Role of Radiotherapy for Sarcoma. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Chen B, Zeng Y, Liu B, Lu G, Xiang Z, Chen J, Yu Y, Zuo Z, Lin Y, Ma J. Risk Factors, Prognostic Factors, and Nomograms for Distant Metastasis in Patients With Newly Diagnosed Osteosarcoma: A Population-Based Study. Front Endocrinol (Lausanne) 2021; 12:672024. [PMID: 34393996 PMCID: PMC8362092 DOI: 10.3389/fendo.2021.672024] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/21/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Osteosarcoma is the most common bone cancer, mainly occurring in children and adolescents, among which distant metastasis (DM) still leads to a poor prognosis. Although nomogram has recently been used in tumor areas, there are no studies focused on diagnostic and prognostic evaluation of DM in primary osteosarcoma patients. METHODS The data of osteosarcoma patients diagnosed between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for DM in osteosarcoma patients, and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors of osteosarcoma patients with DM. We then established two novel nomograms and the results were evaluated by receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). RESULT A total of 1,657 patients with osteosarcoma were included, and 267 patients (16.11%) had DM at the time of diagnosis. The independent risk factors for DM in patients with osteosarcoma include age, grade, T stage, and N stage. The independent prognostic factors for osteosarcoma patients with DM are age, chemotherapy and surgery. The results of ROC curves, calibration, DCA, and Kaplan-Meier (K-M) survival curves in the training, validation, and expanded testing sets, confirmed that two nomograms can precisely predict occurrence and prognosis of DM in osteosarcoma patients. CONCLUSION Two nomograms are expected to be effective tools for predicting the risk of DM for osteosarcoma patients and personalized prognosis prediction for patients with DM, which may benefit clinical decision-making.
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Affiliation(s)
- Bo Chen
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
- The First Clinical College, Wenzhou Medical University, Wenzhou, China
| | - Yuan Zeng
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
- The First Clinical College, Wenzhou Medical University, Wenzhou, China
| | - Bo Liu
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Gaoxiang Lu
- Department of Surgery, The People’s Hospital of Yunhe, Lishui, China
| | - Zhouxia Xiang
- The First Clinical College, Wenzhou Medical University, Wenzhou, China
| | - Jiyang Chen
- The First Clinical College, Wenzhou Medical University, Wenzhou, China
| | - Yan Yu
- The First Clinical College, Wenzhou Medical University, Wenzhou, China
| | - Ziyi Zuo
- The First Clinical College, Wenzhou Medical University, Wenzhou, China
| | - Yangjun Lin
- The First Clinical College, Wenzhou Medical University, Wenzhou, China
| | - Jinfeng Ma
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Jinfeng Ma,
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He P, Xu YQ, Wang ZJ, Sheng B. LncRNA LINC00210 regulated radiosensitivity of osteosarcoma cells via miR-342-3p/GFRA1 axis. J Clin Lab Anal 2020; 34:e23540. [PMID: 32841458 PMCID: PMC7755772 DOI: 10.1002/jcla.23540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/06/2020] [Accepted: 07/24/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Radiotherapy is an effective strategy for preventing cancer metastasis, including osteosarcoma. However, cancer radioresistance limits the efficiency of radiotherapy. Therefore, it is essential to investigate the mechanism of osteosarcoma radioresistance. METHODS The osteosarcoma tissues and adjacent healthy tissues were collected from 53 osteosarcoma patients. The expression of LINC00210, miR-342-3p, and GFRA1 mRNA were determined using qRT-PCR. Cell viability, cell apoptosis, and cell surviving fraction were determined by MTT assay, flow cytometry, and colony formation assay, respectively. Western blot was performed to detect the protein levels. Luciferase assay was conducted to verify the relationship between LINC00210, miR-342-3p, and GFRA1. RESULTS LINC00210 and GFRA1 were up-regulated, and miR-342-3p was down-regulated in osteosarcoma tissues and cells. The expression of LINC00210 in osteosarcoma was negatively related to miR-342-3p expression and positively associated with GFRA1. Besides, there was a negative correlation between LINC00210 and GFRA1 expression in osteosarcoma. Also, LINC00210 and GFRA1 were up-regulated, and miR-342-3p was down-regulated in osteosarcoma cells exposed to 4 Gy irradiation treatment. Furthermore, either LINC00210 knockdown or miR-342-3p overexpression enhanced the radiosensitivity of osteosarcoma cells. Moreover, LINC00210 increased GFRA1 expression via sponging miR-342-3p. Additionally, LINC00210 knockdown improved the radiosensitivity of osteosarcoma cells by regulating GFRA1 expression via sponging miR-342-3p. CONCLUSION LINC00210 modulated the radiosensitivity of osteosarcoma cells via the miR-342-3p/GFRA1 axis, making LINC00210 a novel target for improving radiotherapy efficiency in osteosarcoma.
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Affiliation(s)
- Pan He
- Department of Traumatic and Osteopathy, Hunan Provincial People's Hospital, Changsha, China
| | - Yong-Qiang Xu
- Department of Traumatic and Osteopathy, Hunan Provincial People's Hospital, Changsha, China
| | - Zhi-Jun Wang
- Department of Traumatic and Osteopathy, Hunan Provincial People's Hospital, Changsha, China
| | - Bin Sheng
- Department of Traumatic and Osteopathy, Hunan Provincial People's Hospital, Changsha, China
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Gopishetty S, Yeh J, Khalid M, Annamaraju P, Guddati AK. Locally Advanced Osteosarcoma of the Ethmoid Sinus: A Report of Successful Management. Case Rep Oncol 2020; 13:725-728. [PMID: 32774265 PMCID: PMC7383152 DOI: 10.1159/000507780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 11/19/2022] Open
Abstract
Osteosarcoma of the skull has poor outcomes. This case report describes the presentation and clinical course of a patient who was diagnosed with osteosarcoma of the skull involving the cribriform plate. After her initial diagnosis, she developed esotropia with severe unremitting headaches. She received palliative radiation, followed by chemotherapy, and responded well. Her initial symptoms involving the cranial nerves subsided, and her response was sustained. This report illustrates the need to effectively treat osteosarcoma of the skull despite its reported poor outcomes.
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Affiliation(s)
- Swathi Gopishetty
- Medical Center of Central Georgia, Mercer University, Macon, Georgia, USA
| | - Justin Yeh
- Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Mansoor Khalid
- Mercy Hospital Oklahoma City, Oklahoma City, Oklahoma, USA
| | - Pavan Annamaraju
- Loma Linda Medical Center, Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Achuta K. Guddati
- Division of Hematology/Oncology, Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- *Achuta K. Guddati, Division of Hematology/Oncology, Georgia Cancer Center, Augusta University, Augusta, GA 30909 (USA),
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40
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Kim EH, Kim MS, Takahashi A, Suzuki M, Vares G, Uzawa A, Fujimori A, Ohno T, Sai S. Carbon-Ion Beam Irradiation Alone or in Combination with Zoledronic acid Effectively Kills Osteosarcoma Cells. Cancers (Basel) 2020; 12:cancers12030698. [PMID: 32187978 PMCID: PMC7140041 DOI: 10.3390/cancers12030698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 12/11/2022] Open
Abstract
Osteosarcoma (OSA) is the most common malignant bone tumor in children and adolescents. The overall five-year survival rate for all bone cancers is below 70%; however, when the cancer has spread beyond the bone, it is about 15–30%. Herein, we evaluated the effects of carbon-ion beam irradiation alone or in combination with zoledronic acid (ZOL) on OSA cells. Carbon-ion beam irradiation in combination with ZOL significantly inhibited OSA cell proliferation by arresting cell cycle progression and initiating KHOS and U2OS cell apoptosis, compared to treatments with carbon-ion beam irradiation, X-ray irradiation, and ZOL alone. Moreover, we observed that this combination greatly inhibited OSA cell motility and invasion, accompanied by the suppression of the Pi3K/Akt and MAPK signaling pathways, which are related to cell proliferation and survival, compared to individual treatments with carbon-ion beam or X-ray irradiation, or ZOL. Furthermore, ZOL treatment upregulated microRNA (miR)-29b expression; the combination with a miR-29b mimic further decreased OSA cell viability via activation of the caspase 3 pathway. Thus, ZOL-mediated enhancement of carbon-ion beam radiosensitivity may occur via miR-29b upregulation; co-treatment with the miR-29b mimic further decreased OSA cell survival. These findings suggest that the carbon-ion beam irradiation in combination with ZOL has high potential to increase OSA cell death.
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Affiliation(s)
- Eun Ho Kim
- Department of Biochemistry, School of Medicine, Daegu Catholic University, Nam-gu, Daegu 42472, Korea
- Correspondence: (E.H.K.); (S.S.); Tel.: +82-53-650-4480 (E.H.K.); +81-43-206-3231 (S.S.)
| | - Mi-Sook Kim
- Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul 139-706, Korea;
| | - Akihisa Takahashi
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, Japan;
| | - Masao Suzuki
- Department of Basic Medical Sciences for Radiation Damages, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba 263-8555, Japan; (M.S.); (A.U.); (A.F.)
| | - Guillaume Vares
- Cell Signal Unit, Okinawa Institute of Science and Technology Graduate University (OIST), Onna-son 904-0495, Okinawa, Japan;
| | - Akiko Uzawa
- Department of Basic Medical Sciences for Radiation Damages, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba 263-8555, Japan; (M.S.); (A.U.); (A.F.)
| | - Akira Fujimori
- Department of Basic Medical Sciences for Radiation Damages, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba 263-8555, Japan; (M.S.); (A.U.); (A.F.)
| | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, Japan;
| | - Sei Sai
- Department of Basic Medical Sciences for Radiation Damages, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba 263-8555, Japan; (M.S.); (A.U.); (A.F.)
- Correspondence: (E.H.K.); (S.S.); Tel.: +82-53-650-4480 (E.H.K.); +81-43-206-3231 (S.S.)
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Baranowska-Kortylewicz J, Sharp JG, McGuire TR, Joshi S, Coulter DW. Alpha-Particle Therapy for Multifocal Osteosarcoma: A Hypothesis. Cancer Biother Radiopharm 2020; 35:418-424. [PMID: 32073902 DOI: 10.1089/cbr.2019.3112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Osteosarcoma (OST) is the most common bone tumor in children and adolescents with a second peak of incidence in elderly adults usually diagnosed as secondary tumors in Paget's disease or irradiated bone. Subjects with metastatic disease or whose disease relapses after the initial therapy have a poor prognosis. Moreover, multifocal OST contains tumor-initiating cells that are resistant to chemotherapy. The use of aggressive therapies in an attempt to eradicate these cells can have long-term negative consequences in these vulnerable patient populations. 227Th-labeled molecular probes based on ligands to OST-associated receptors such as IGF-1R (insulin-like growth factor receptor 1), HER2 (human epidermal growth factor receptor 2), and PSMA (prostate-specific membrane antigen) are expected to detect and treat osseous and nonosseous sites of multifocal OST. Published reports indicate that 227Th has limited myelotoxicity, can be stably chelated to its carriers and, as it decays at targeted sites, 227Th produces 223Ra that is subsequently incorporated into the areas of increased osteoblastic activity, that is, osseous metastatic lesions. Linear energy transfer of α particles emitted by 227Th and its daughter 223Ra is within the range of the optimum relative biological effectiveness. The radiotoxicity of α particles is virtually independent of the phase in the cell cycle, oxygenation, and the dose rate. For these reasons, even resistant OST cells remain susceptible to killing by high-energy α particles, which can also kill adjacent quiescent OST cells or cells with low expression of targeted receptors. Systemic side effects are minimized by the limited range of these intense radiations. Quantitative single-photon emission computed tomography of 227Th and 223Ra is feasible. Additionally, the availability of radionuclide pairs, for example, 89Zr for positron emission tomography and 227Th for therapy, establish a strong basis for the theranostic use of 227Th in the individualized treatment of multifocal OST.
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Affiliation(s)
- Janina Baranowska-Kortylewicz
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - John G Sharp
- Department of Genetics Cell Biology & Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Timothy R McGuire
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Shantharam Joshi
- Department of Genetics Cell Biology & Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Don W Coulter
- Division of Hematology/Oncology, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Sun HB, Wang HY, Wu B, Wang ZF, Wang LZ, Li FQ, Wu JD, Zhang LN. The inhibitory effects of cisplatin-radiation combination treatment on malignant osteosarcoma MG-63 cells and BRCA1-p53 pathways are more efficient than single treatments. Oncol Lett 2019; 18:6385-6396. [PMID: 31807162 PMCID: PMC6876329 DOI: 10.3892/ol.2019.11019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/22/2019] [Indexed: 01/07/2023] Open
Abstract
The poor prognosis of patients with osteosarcoma remains a persistent problem, in particular for patients with unresectable tumors or metastasis. Therefore, combination of radiotherapy and chemotherapy has been considered for patients with metastasis or recurrence, patients unsuitable for surgery and patients refusing surgery. The present study aimed to investigate the effect of the combined treatment with cisplatin and radiation therapy on the biological characteristics of the osteosarcoma cell line MG-63 and the breast cancer 1 (BRCA1)-associated signaling pathways. Cell proliferation was determined using Cell Counting kit-8 assay, and cell apoptosis and cell cycle were assessed by flow cytometry. Cell migration was examined by Transwell assay. The mRNA and protein expression levels of candidate genes, including BRCA1 and p53, were determined by reverse transcription-quantitative PCR and western blotting, respectively. The results demonstrated that combined treatment with radiation and cisplatin significantly inhibited MG-63 cell proliferation compared with radiation or cisplatin treatment alone. Furthermore, radiation, cisplatin or the combined treatment with radiation and cisplatin increased the apoptosis rate of MG-63 cells, which resulted in G2 phase arrest, and significantly decreased the migratory capacity of MG-63 cells. In addition, the apoptosis rate of MG-63 cells following combined radiation and cisplatin treatment was higher compared with the cisplatin group, but lower compared with the radiation group. Furthermore, combined treatment with radiation and cisplatin decreased the mRNA and protein expression levels of BRCA1 and p53. Additionally, combined treatment with radiation and cisplatin had a more potent inhibitory effect on p53 expression than on BRCA1 expression. In addition, combination of radiation and cisplatin had a higher inhibitory effect on Bax protein level and a higher inductive effect on Bcl-2 protein level compared with treatments with radiation and cisplatin alone. The results demonstrated that combined treatment of radiation and cisplatin exhibited superior therapeutic effects on osteosarcoma MG-63 cells compared with radiation or cisplatin treatment alone, which may be mediated by the BRCA1-p53 signaling pathway.
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Affiliation(s)
- Hong-Bin Sun
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - He-Yuan Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Bing Wu
- Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Zhong-Feng Wang
- Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Li-Zhe Wang
- Department of Pediatric Oncology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Fu-Qiang Li
- Eye Center of The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Jun-Duo Wu
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Le-Ning Zhang
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
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Zhou H, Chen S, Yang Y, Yang C, Chen D, Yao Z, Sun B. Matrine enhances the efficacy of adriamycin chemotherapy in osteosarcoma cells by the STAT3 pathway. Anticancer Drugs 2019; 30:1006-1012. [PMID: 31609759 DOI: 10.1097/cad.0000000000000796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Matrine and adriamycin have been extensively considered to be effective in anticancer therapies. However, the role of matrine in the antitumor activity of adriamycin against human osteosarcoma (OS) remains elusive. The aim of this study was to investigate the effect of matrine in OS chemotherapy of adriamycin. In the study, we found that matrine promoted the inhibitory effect of adriamycin against OS cell proliferation and growth. Wound healing and transwell assays showed that the inhibitory effect of adriamycin against migration and invasion of OS cells was significantly enhanced by matrine. For the underlying mechanism investigation, we showed that adriamycin reduced the protein level of PCNA, MMP-9, phosphorylated STAT3, and survivin, which was further intensified by the application of matrine. These results show that matrine could promote the therapeutic efficacy of adriamycin against human OS.
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Affiliation(s)
| | | | | | | | - Danping Chen
- Department of Neurology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Zhenrong Yao
- Laboratory, The First Affiliated Hospital of Sun Yat-Sen University
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Wang Z, Wu B, Zhou Y, Huang X, Pan W, Liu M, Yan X, Lin N, Ye Z. Predictors of the Survival of Primary and Secondary Older Osteosarcoma Patients. J Cancer 2019; 10:4614-4622. [PMID: 31528225 PMCID: PMC6746122 DOI: 10.7150/jca.32627] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 06/07/2019] [Indexed: 01/23/2023] Open
Abstract
Purpose: Older osteosarcoma patients have a very poor prognosis and treatment for them remains a challenge. The outcomes and potential prognostic factors of primary or secondary older osteosarcoma patients are rarely documented. Therefore, we examined the prognosis of the two special cohorts to identify possible prognostic factors, and provide optimal treatment strategy for them. Methods: The Surveillance, Epidemiology, and End Results (SEER) program database was used to identify osteosarcoma patients aged over 40 years from 1973 to 2015. The prognostic analysis was performed using the Kaplan-Meier method and a Cox proportional hazards regression model. Results: In total, 1162 primary older osteosarcoma patients and 444 secondary older osteosarcoma patients were eligible for this study. The OS and CSS rates of the primary older osteosarcoma patients at 5-year were 38.5% and 37.1%, respectively. The 3- and 5-year OS rates of the secondary older osteosarcoma patients were 22.8% and 14.6%, respectively. On multivariate analysis of the primary older osteosarcoma patients, age > 60, male, axial site, high grade, metastasis, tumor size>10 cm, no surgery, and radiation treatment were negatively associated with OS. In terms of CSS, age, gender, decade of diagnosis, tumor site, tumor grade, tumor stage, tumor size, and surgery were independent prognostic factors. A multivariate Cox regression model showed that secondary older osteosarcoma patients of high grade, metastasis, tumor size > 10 cm, no surgery, and no chemotherapy were independent predictors of decreased OS. Conclusions: Surgery in combination with chemotherapy should be recommended for the treatment of the secondary older osteosarcoma patients, while for the primary older osteosarcoma patients, only surgery should be recommended.
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Affiliation(s)
- Zhan Wang
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Bo Wu
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Yuanxi Zhou
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Xin Huang
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Weibo Pan
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Meng Liu
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Xiaobo Yan
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Nong Lin
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
| | - Zhaoming Ye
- Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310000, P.R. China
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Tinkle CL, Lu J, Han Y, Li Y, McCarville BM, Neel MD, Bishop MW, Krasin MJ. Curative-intent radiotherapy for pediatric osteosarcoma: The St. Jude experience. Pediatr Blood Cancer 2019; 66:e27763. [PMID: 31012273 PMCID: PMC6588458 DOI: 10.1002/pbc.27763] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Radiation therapy (RT) confers local tumor control and survival advantages in some patients with osteosarcoma, yet pediatric and adolescent and young adult (AYA) population studies are limited. METHODS Twenty-eight patients treated with curative-intent RT (median dose, 59.4 Gy; range, 40-76 Gy) at our institution from 1990 to 2017 were retrospectively identified. Cumulative incidence (CIN) of local failure (LF) was estimated by Gray's method and overall survival (OS) by the Kaplan-Meier method. Competing-risk regression and Cox proportional hazards models determined predictors of outcome. Toxicity was reported according to CTCAE v4.0. RESULTS With a median follow-up of 99.1 months in living patients, nine patients (32.1%) developed LF. Estimated CINs of LF with competing risk of death at 5 years for the entire cohort, patients at initial diagnosis (n = 16), and recurrent/refractory patients (n = 12) were 32.7% (95% CI, 16.0-50.5%), 25.0% (95% CI, 7.3-48.0%), and 43.8% (95% CI, 13.6-71.0%), respectively (P = 0.31). Estimated 5-year OS was 42.6% (95% CI, 23.2-62.0%), 54.6% (95% CI, 29.5-79.6%), and 24.3% (95% CI, 0-52.2%), respectively (P = 0.15). No clinicopathologic features were significantly associated with LF, yet lack of chemotherapy or metastasis at the time of RT was independent significant prognostic factors of decreased OS. Eleven patients experienced RT-related morbidity, with two grade 3 toxicities and no grade 4/5 events. CONCLUSIONS Curative-intent RT in pediatric and AYA patients was well tolerated and achieved a local tumor control rate of 75% in patients with primary disease. Local control rates were similar to those in primarily adult studies, with similar or lower doses.
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Affiliation(s)
- Christopher L. Tinkle
- Departments of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee.,Correspondence: Christopher L. Tinkle, MD, PhD; St. Jude Children’s Research Hospital; 262 Danny Thomas Place, MS 210; Memphis, TN 38105. Tel: (901) 595-3226; Fax: (901) 595-3113;
| | - Jason Lu
- Departments of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Yuanyuan Han
- Departments of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Yimei Li
- Departments of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Beth M. McCarville
- Departments of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Michael D. Neel
- Departments of Surgery, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Michael W. Bishop
- Departments of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Matthew J. Krasin
- Departments of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
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Tsagozis P, Laitinen MK, Stevenson JD, Jeys LM, Abudu A, Parry MC. Treatment outcome of patients with chondroblastic osteosarcoma of the limbs and pelvis. Bone Joint J 2019; 101-B:739-744. [PMID: 31154835 DOI: 10.1302/0301-620x.101b6.bjj-2018-1090.r1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The aim of this study was to identify factors that determine outcomes of treatment for patients with chondroblastic osteosarcomas (COS) of the limbs and pelvis. PATIENTS AND METHODS The authors carried out a retrospective review of prospectively collected data from 256 patients diagnosed between 1979 and 2015. Of the 256 patients diagnosed with COS of the pelvis and the limbs, 147 patients (57%) were male and 109 patients (43%) were female. The mean age at presentation was 20 years (0 to 90). RESULTS In all, 82% of the patients had a poor response to chemotherapy, which was associated with the presence of a predominantly chondroblastic component (more than 50% of tumour volume). The incidence of local recurrence was 15%. Synchronous or metachronous metastasis was diagnosed in 60% of patients. Overall survival was 51% and 42% after five and ten years, respectively. Limb localization and wide surgical margins were associated with a lower risk of local recurrence after multivariable analysis, while the response to chemotherapy was not. Local recurrence, advanced patient age, pelvic tumours, and large volume negatively influenced survival. Resection of pulmonary metastases was associated with a survival benefit in the limited number of patients in whom this was undertaken. CONCLUSION COS demonstrates a poor response to chemotherapy and a high incidence of metastases. Wide resection is associated with improved local control and overall survival, while excision of pulmonary metastases is associated with improved survival in selected patients. Cite this article: Bone Joint J 2019;101-B:739-744.
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Affiliation(s)
- P Tsagozis
- Karolinska University Hospital, Stockholm, Sweden.,Karolinska Institutet, Stockholm, Sweden.,The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - M K Laitinen
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.,The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - J D Stevenson
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - L M Jeys
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - A Abudu
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - M C Parry
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
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Provenzano L, Bortolussi S, González SJ, Postuma I, Protti N, Portu A, Olivera MS, Rodriguez LM, Fregenal D, Altieri S. Charged particle spectrometry to measure 10B concentration in bone. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:237-245. [PMID: 30689023 DOI: 10.1007/s00411-018-00776-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/24/2018] [Indexed: 06/09/2023]
Abstract
Osteosarcoma is the most common primary malignant tumour of bone in young patients. The survival of these patients has largely been improved due to adjuvant and neo-adjuvant chemotherapy in addition to surgery. Boron neutron capture therapy (BNCT) is proposed as a complementary therapy, due to its ability to inactivate tumour cells that may survive the standard treatment and that may be responsible for recurrences and/or metastases. BNCT is based on neutron irradiation of a tumour enriched in 10B with a boron-loaded drug. Low-energy neutron capture in 10B creates charged particles that impart a high dose to tumour cells, which can be calculated only knowing the boron concentration. Charged particle spectrometry is a method that can be used to quantify boron concentration. This method requires acquisition of the energy spectra of charged particles such as alpha particles produced by neutron capture reactions in thin tissue sections irradiated with low-energy neutrons. Boron concentration is then determined knowing the stopping power of the alpha particles in the sample material. This paper describes the adaptation of this method for bone, with emphasis on sample preparation, experimental set-up and stopping power assessment of the involved alpha particles. The knowledge of boron concentration in healthy bones is important, because it allows for any dose limitation that might be necessary to avoid adverse effects such as bone fragility. The measurement process was studied through Monte Carlo simulations and analytical calculations. Finally, the boron content of bone samples was measured by alpha spectrometry at the TRIGA reactor in Pavia, Italy, and compared to that obtained by neutron autoradiography. The agreement between the results obtained with these techniques confirms the suitability of alpha spectrometry to measure boron in bone.
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Affiliation(s)
- Lucas Provenzano
- National Atomic Energy Commission (CNEA), Av.de los Constituyentes 1499, Buenos Aires, Argentina.
- National Scientific and Technical Research Council (CONICET), Av. Godoy Cruz 2290, Buenos Aires, Argentina.
| | - Silva Bortolussi
- Department of Physics, University of Pavia, via Bassi 6, 27100, Pavia, Italy
- Unit of Pavia, National Institute of Nuclear Physics (INFN), via Bassi 6, 27100, Pavia, Italy
| | - Sara J González
- National Atomic Energy Commission (CNEA), Av.de los Constituyentes 1499, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Av. Godoy Cruz 2290, Buenos Aires, Argentina
| | - Ian Postuma
- Unit of Pavia, National Institute of Nuclear Physics (INFN), via Bassi 6, 27100, Pavia, Italy
| | - Nicoletta Protti
- Unit of Pavia, National Institute of Nuclear Physics (INFN), via Bassi 6, 27100, Pavia, Italy
| | - Agustina Portu
- National Atomic Energy Commission (CNEA), Av.de los Constituyentes 1499, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Av. Godoy Cruz 2290, Buenos Aires, Argentina
| | - Maria Silvina Olivera
- National Atomic Energy Commission (CNEA), Av.de los Constituyentes 1499, Buenos Aires, Argentina
| | - Luis Miguel Rodriguez
- National Scientific and Technical Research Council (CONICET), Av. Godoy Cruz 2290, Buenos Aires, Argentina
- National Atomic Energy Commission (CNEA), Bariloche, Argentina
| | - Daniel Fregenal
- National Scientific and Technical Research Council (CONICET), Av. Godoy Cruz 2290, Buenos Aires, Argentina
- National Atomic Energy Commission (CNEA), Bariloche, Argentina
| | - Saverio Altieri
- Department of Physics, University of Pavia, via Bassi 6, 27100, Pavia, Italy
- Unit of Pavia, National Institute of Nuclear Physics (INFN), via Bassi 6, 27100, Pavia, Italy
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Abstract
PURPOSE OF REVIEW Osteosarcoma and Ewing sarcoma, the most common primary bone tumours in young people, are curable in most patients. However, these tumours remain a significant challenge due to the complexity and intensity of treatment and its long-term morbidity and the significant proportion of patients in whom treatment is unsuccessful. This review addresses questions about current management and emerging therapeutic targets for patients with osteosarcoma, Ewing sarcoma and chondrosarcoma, the commonest bone sarcoma but more common in older patients. RECENT FINDINGS The largest collaborative international study in osteosarcoma, EURAMOS-1 determined that treatment of patients with resectable disease should not be altered on basis of pathological response to neoadjuvant chemotherapy. In view of little improvement in outcome being evident in recent years, novel therapeutic approaches are required. Putative targets and clinical trials of novel agents are discussed, including emerging targets such as poly (ADP-ribose) polymerase inhibition and isocitrate dehydrogenase inhibition in Ewing sarcoma and chondrosarcoma, respectively. Newer radiotherapy techniques including proton beam and particle ion therapy may be important for local tumour control in selected patients. SUMMARY Collaborative studies are essential to answer current questions and investigate novel therapies in these malignancies to improve outcome and quality of life for patients.
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[Radiotherapy after tumour prostheses-status, indication, coordination]. DER ORTHOPADE 2019; 48:605-609. [PMID: 30919000 DOI: 10.1007/s00132-019-03722-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Patients with complex tumour prostheses often require radiotherapy or radiochemotherapy. OBJECTIVES Possible tumour diagnoses, indications, planning and therapy procedures, and prognosis of radiotherapy in the context of an interdisciplinary treatment for bone sarcomas are reviewed, including interactions of metal prostheses with radiation and possible subsequent complications. METHODS Literature search, summary of personal experience. RESULTS Complex prosthetic procedures are usually applied to patients suffering from Ewing sarcoma or osteosarcoma. In patients with Ewing sarcoma, radiotherapy is an integral part of multimodal treatment, while in patients with osteosarcoma radiotherapy is indicated in special situations. Planning and implementation of radiotherapy treatment can be impaired by metal implants within the target volume (artefacts in the planning computerized tomography, interaction of metal with the therapeutic beam). However, it is-to our knowledge-a point of debate whether radiotherapy after implantation of a prosthesis could impair healing or prosthesis fixation to bone. The data available in the literature suggest that prostheses implanted after radiotherapy entail a higher rate of complications. Multidisciplinary treatment improves the prognosis for these patients markedly. CONCLUSIONS Patients with sarcomas of the bone undergoing interdisciplinary treatment consisting of surgery, radiotherapy and chemotherapy have a favourable prognosis and an acceptable functionality of the limb can be expected.
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Martin E, Senders JT, ter Wengel PV, Smith TR, Broekman MLD. Treatment and survival of osteosarcoma and Ewing sarcoma of the skull: a SEER database analysis. Acta Neurochir (Wien) 2019; 161:317-325. [PMID: 30578430 PMCID: PMC6373276 DOI: 10.1007/s00701-018-3754-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/26/2018] [Indexed: 11/27/2022]
Abstract
Background Common primary bone tumors include osteosarcomas (OSC) and Ewing sarcomas (EWS). The skull is a rare site, and literature about their treatment and survival is scarce. Using the Surveillance, Epidemiology, and End Results (SEER) database, this study aims to assess the treatment and survival of skull OSC and skull EWS, as well as predictors for survival. Methods Skull OSC and EWS cases were obtained from the SEER database. Patient and tumor characteristics, treatment modalities, and survival were extracted. Overall survival (OS) was assessed using multivariable Cox proportional hazard regression stratified by tumor histology. Kaplan-Meier curves were constructed for OS comparing OSC and EWS, as well as histological subtypes in OSC. Results A total of 321 skull OSC and 80 skull EWS patients were registered from 1973 to 2013. EWS was more common in younger patients (p < 0.001). Resection was the predominant treatment strategy (80.1%), frequently in combination with adjuvant radiotherapy (30.4%). The 5-year survival rate varied significantly between OSC and EWS (51.0% versus 68.5%, p = 0.02). Kaplan-Meier curves show that EWS had a significantly better survival compared to OSC. Comparing histological subtypes of skull OSC, chondroblastic OSC had the best OS, Paget OSC the worst. Older age, tumor advancement, no surgical treatment, and the use of radiotherapy were identified as independent predictors of decreased OS in skull OSC. Conclusion Overall prognosis is better for EWS compared to OSC. Chondroblastic OSC have the best overall survival, while OSC associated with Paget’s disease of the bone has the poorest overall survival.
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