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Role of radiation therapy for pediatric upper extremity extraskeletal osteosarcoma: A case series.

儿童上肢骨外骨肉瘤放射治疗的作用: 病例系列。

  • 影响因子:2.28
  • DOI:10.1002/pbc.28018
  • 作者列表:"McClelland S 3rd","Hentea C","Fan R","Bertrand TE","Holmes JA
  • 发表时间:2020-02-01
Abstract

BACKGROUND:Extraskeletal osteosarcoma is an extremely rare disease, comprising less than 0.1% of all cancers diagnosed in the United States, of which less than 5% occur in the upper extremities. The management of two cases of pediatric upper extremity extraskeletal osteosarcoma is discussed. CASE DESCRIPTION:Two children initially noticed painless left upper extremity masses at the ages of 16 and 13, respectively. Following a period of several months, both lesions became symptomatic, necessitating operative intervention, which revealed giant cell-rich extraskeletal osteosarcoma; PET staging following gross total resection revealed no residual or metastatic disease in either patient. After extensive discussion with the patients and family, adjuvant chemotherapy was initiated for one patient, and adjuvant radiation therapy was initiated in both patients. CONCLUSIONS:Despite the rarity of these tumors, the importance of radiation therapy has been established by current and ongoing studies such as the Children's Oncology Group study ARST0332. Radiation therapy remains an important component of the multimodality therapy comprising optimal treatment of this disease, despite the relative paucity of long-term outcome data derived from level I evidence.

摘要

背景: 骨外骨肉瘤是一种极其罕见的疾病,在美国诊断的所有癌症中不到 0.1%,其中不到 5% 发生在上肢。本文对 2 例小儿上肢骨外骨肉瘤的治疗进行了讨论。 病例描述: 2 例患儿分别在 16 岁和 13 岁时初步注意到左侧上肢无痛性肿块。几个月后,两个病灶都出现症状,需要手术干预,这显示富含巨细胞的骨外骨肉瘤; 大体全切后PET分期未发现任何患者残留或转移性疾病。与患者及家属广泛讨论后,对 1 例患者启动辅助化疗,对 2 例患者均启动辅助放疗。 结论: 尽管这些肿瘤很罕见,但目前和正在进行的研究已经确定了放射治疗的重要性,如儿童肿瘤组研究arst0332。放射治疗仍然是包括最佳治疗这种疾病的综合治疗的重要组成部分,尽管相对缺乏来自I级证据的长期结果数据。

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影响因子:2.12
发表时间:2020-03-01
DOI:10.1259/bjr.20180883
作者列表:["Tran S","Puric E","Walser M","Poel R","Datta NR","Heuberger J","Pica A","Marder D","Lomax N","Bolsi A","Morach P","Bachtiary B","Seddon BM","Schneider R","Bodis S","Weber DC"]

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.

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影响因子:2.83
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DOI:10.1007/s00520-019-04843-9
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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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