Features of the clinical course and treatment of osteosarcoma in children

The clinical course and treatment of osteosarcoma in 500 patients under the age of 16 are analyzed. The features of the disease at the indicated age include early metastasis and significant local spread of the tumor. The average time to detect metastases was 3.3 months. The epiphyseal cartilage plate is not an obstacle to tumor growth. The defeat of the knee joint was found in 65% of patients. The results of the primary amputation are unsatisfactory. Immediate amputation is indicated only in case of intoxication and the impossibility of carrying out combined treatment. In 52% of children, as a result of irradiation, tumor growth stopped. Radiation treatment at a dose of 60-90 Gy was used only in combination with surgery and chemotherapy, which was used before and after surgery and radiation. In connection with the early dissemination and significant spread of the tumor, a two-stage complex treatment was used.At the first stage, chemotherapy and radiation therapy were performed. In case of refusal of the operation or detection of metastases, such treatment became the main and final one. The second stage is a radical operation performed after 3-6 months in the absence of metastases and stabilization of tumor growth. This tactic facilitates the selection of patients for surgical treatment and avoids mutilation in children with an unfavorable course of the disease.