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Primary Bone Tumors
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Jeremy S. Whelan, Rob C. Pollock, Rachael E. Windsor, Mahbubl Ahmed
Almost all bone biopsies nowadays are CT-guided core needle biopsies, and this has been shown to improve diagnostic accuracy.6 It is unacceptable to operate on a potentially malignant bone tumor without first identifying the tissue diagnosis. There is, therefore, no role for excision biopsy in the management of primary malignant bone tumors. Incision biopsy is rarely performed on the occasions when more than two core needle biopsies are non-diagnostic. The same principles apply as far as the planning and execution of the biopsy are concerned.
Primary bone tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Jennifer N Murphy, Steven L J James, Murali Sundaram, A Mark Davies
Primary malignant bone tumours are rare and can radiologically and clinically resemble a number of benign conditions. A logical approach to imaging bone lesions is required to formulate a differential diagnosis and provide recommendations for further imaging and biopsy. In the initial diagnosis and staging of bone tumours, imaging often includes the combination of radiographs, CT, and MRI. Radiographs remain paramount in the initial detection and assessment of bone tumours, while CT is reserved for those cases which are difficult to visualize on radiographs. MRI is most accurate in local staging and characterization of bone tumours. In addition, whole-body MRI is used in distant staging, particularly in children as an alternative to bone scintigraphy and in patients with Ewing's sarcoma. The role of functional MRI techniques and PET-CT in both the initial evaluation of bone tumours and in treatment response have also been investigated. The WHO classification of bone tumours is based on both histological and genetic criteria and incorporates both benign and malignant bone tumours. In recent years, image-guided percutaneous biopsy has become the standard procedure for obtaining tissue from bone neoplasms for histological diagnosis. Appropriate planning, following multidisciplinary discussion, according to anatomic boundaries, and planned surgical approach is required.
Radiation Carcinogenesis: Human Model
Published in Kedar N. Prasad, Handbook of RADIOBIOLOGY, 2020
Primary cancers of the bone have been induced by high doses of therapeutic X-rays and by α-emitters.42–58 Osteosarcomas are the most common form of bone tumor. The incidence of osteosarcoma in the normal population is 1/200,000. Table 19.4 summarizes the results of several studies. The threshold skeletal dose from 224Ra for the induction of osteosarcoma is 67–90 rads.51 A recent study52 shows that the threshold for accumulative radiation dose to induce bone tumor is 50–110 rads for mice, dogs, and humans. The accumulative dose required to give significant cancer risk is much less at lower dose rates than at higher dose rates, i.e., the higher dose rate produces more tumor. Based on German patients who received 224Ra, the risk of bone sarcoma is 54 cases per 106 patients per year/rad after a single injections and 200 cases per 106/rad after multiple injection.51 The therapeutic radiation dose of 3000 rads (fractionated) may induce osteosarcoma.60 The latent period under conditions of continuous radiation could be as long as 52 years.54
Phytic acid-modified manganese dioxide nanoparticles oligomer for magnetic resonance imaging and targeting therapy of osteosarcoma
Published in Drug Delivery, 2023
Qian Ju, Rong Huang, Ruimin Hu, Junjie Fan, Dinglin Zhang, Jun Ding, Rong Li
Osteosarcoma is the most common malignant tumor in the skeletal system, accounting for 20%–34% of the primary malignant bone tumor with extreme invasiveness and metastasis as well as dismal prognosis (Rathore & Van Tine, 2021). Currently, surgery was the preponderant clinical treatment, but only patients with early-stage osteosarcoma could be cured via surgical resection. In addition, the five-year survival rate after surgery was less than 70% (Siegel et al., 2021). Surgery combined with neoadjuvant chemotherapy can significantly increase the survival rate of patients. Classical anticancer drugs such as cisplatin, doxorubicin, and methotrexate have shown good therapeutic effects to osteosarcoma (Jiang et al., 2022). However, chemical drugs are likely to cause numerous side effects and bone marrow microenvironment-associated drug resistance is inevitable (Yang & Tian et al., 2020).
Bone tumors effective therapy through functionalized hydrogels: current developments and future expectations
Published in Drug Delivery, 2022
Ruyi Shao, Yeben Wang, Laifeng Li, Yongqiang Dong, Jiayi Zhao, Wenqing Liang
Bone cancer is a type of tumor that develops in the bone and kills normal bone tissues. It might be benign or cancerous. The tumor grows and compresses the normal bone tissues in both cases, however benign tumors lack the ability to metastasize and therefore do not spread to other organs of the body. Benign bone tumors can progress to malignancy and pose a risk if remain untreated. Benign bone tumors include osteochondroma, osteoma, osteoblastoma, fibrous dysplasia, and enchondroma (Hakim et al., 2015). According to the World Health Organization (WHO), bone cancers are classified as primary or secondary tumors (Sisu et al., 2012) and categorized over 45 distinct forms of bone tumors in 2002 based on their findings. Among the many kinds of bone tumors, Osteosarcoma is the most common and major type of bone tumor, accounting for 31.5% of all cases, followed by angiosarcoma (1.4%), malignant fibrous histitocytoma (5.7%), chondroma (8.4%), Ewing’s sarcoma (16%), and chondrosarcoma (25.8%) (Sisu et al., 2012; Jemal et al., 2005). Secondary bone tumors are usually malignant and develop as a result of soft tissue metastasizing tumors in the breast, liver, or lung. As per the American Cancer Society, the number of joint and bone cancer diagnoses and deaths rises each year (Miller et al., 2019).
Cancer bone metastases and nanotechnology-based treatment strategies
Published in Expert Opinion on Drug Delivery, 2022
Zhaofeng Li, Wei Zhang, Zhong Zhang, Huile Gao, Yi Qin
Clinical issues affecting prognosis and quality of life in patients with bone metastases include pathological fractures, hypercalcemia, cancer pain, and nerve compression. Based on the understanding of the ‘vicious cycle’ between cancer cells and osteoclasts, clinicians have carried out a number of studies on applying antiresorptive drugs in combination with antitumor drugs. The results suggested that the use of antiresorptive drugs can help improve survival and prognosis in selected patients [61]. Most of the research reported on bone tumor nanomedicine research to date attempts to inhibit both bone tumors and bone resorption. However, inhibition of bone resorption alone cannot effectively restore tumor-associated bone destruction, and the promotion of bone formation mediated by osteoblasts is also needed. Therefore, increasing osteogenesis-promoting cytokines or drugs in nanocarriers is an important direction for treating pathological fractures in the future. In addition, cancer pain is a prominent clinical symptom in patients with bone metastases and significantly affects the quality of life of patients. Current tertiary cancer pain management still cannot effectively address the needs of patients. Previous studies have evaluated the role of nanoparticles in relieving cancer pain while exploring the effect of nanoparticles on inhibiting bone metastases, providing new insights into cancer pain treatment [106,117]. However, the further development of more targeted nanomedicines is still needed to provide effective bone pain relief strategies for addressing the needs of patients.