Dedifferentiated Chondrosarcoma: The Role of Chemotherapy with Updated Outcomes

Dickey, Ian D.; Rose, Peter S.; Fuchs, Bruno; Wold, Lester E.; Okuno, Scott H.; Sim, Franklin H.; Scully, Sean P.

doi:10.2106/00004623-200411000-00008

Cited by 175 publications

(172 citation statements)

References 13 publications

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“…One study seemed to show an effect on survival [77], which was not confirmed by others [37,78,79]. For peripheral dedifferentiated chondrosarcoma, arising in osteochondroma, chemotherapy led to longer survival in a small retrospective report [80].…”

Section: Systemic Treatmentmentioning

confidence: 92%

The Clinical Approach Towards Chondrosarcoma

et al. 2008

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After completing this course, the reader will be able to:1. Classify the chondrosarcoma subtypes.2. Engage in the diagnostic process of chondrosarcoma.3. Evaluate the treatment options for chondrosarcoma.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTThis review provides an overview of the histopathology, classification, diagnostic procedures, and therapy of skeletal chondrosarcoma. Chondrosarcomas that arise de novo are primary chondrosarcomas, whereas chondrosarcomas developing superimposed on pre-existing benign cartilage neoplasms such as enchondromas or osteochondromas are referred to as secondary chondrosarcomas. Conventional chondrosarcomas can be categorized according to their location in bone into central, peripheral, and juxtacortical chondrosarcomas. Histological grading is related to prognosis; however, it is also subject to interobserver variability. Rare subtypes of chondrosarcoma, including dedifferentiated, mesenchymal, and clear cell chondrosarcoma, are discussed as well. Magnetic resonance imaging is necessary to delineate the extent of the intraosseous and soft tissue involvement preoperatively. Computed tomography is especially recommended in the pelvis and other flat bones where it may be difficult to discern the pattern of bone destruction and the presence of matrix mineralization. Wide, en-bloc excision is the preferred surgical treatment in intermediate-and high-grade chondrosarcoma. In low-grade chondrosarcoma confined to the bone, extensive intralesional curettage followed by local adjuvant treatment and filling the cavity with bone graft has promising long-term clinical results and satisfactory local control. Chondrosarcomas are relatively radiotherapy resistant; therefore, doses >60 Gy are needed in attempts to achieve local control after incomplete resection. Irradiation with protons or other charged particles seems beneficial in this curative situation. Chemotherapy is only possibly effective in mesenchymal chondrosarcoma, and is of uncertain value in dedifferentiated chondrosarcoma. Potential new systemic treatment targets are being discussed. The Oncologist 2008;13:320 -329

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Section: Systemic Treatmentmentioning

confidence: 92%

The Clinical Approach Towards Chondrosarcoma

et al. 2008

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“…For all grades of non-metastatic chondrosarcoma en-block resection offers the best recurrence free survival, surgical management is related to grade, type and site. Chemotherapy is possibly effective in mesenchymal chondrosarcoma, and of uncertain value in dedifferentiated chondrosarcoma [2,3]. There is an urgent need for new treatment options for bone cancer patients.…”

Section: Introductionmentioning

confidence: 99%

3D printing of PCL/Fluorouracil tablets by selective laser sintering: Properties of implantable drug delivery for cartilage cancer treatment

Gv¹,

Fe²,

Gb³

et al. 2017

Rheumatol Orthop Med

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In this study, implantable polycaprolactone/fluorouracil tablets were additively manufactured by selective laser sintering using different laser power levels. PCL/FU tablets showed on SEM-EDS small particles of fluorouracil dispersed on the surface and into the porous PCL matrix. The crystallinity values for the PCL/FU tablets were lower than for the pure PCL tablets, probably due to interaction of the FU particles with the polymer chains during the solidification process. The PCL/FU tablets prepared using the higher laser power (7 W) had the highest flexural modulus, probably due to better PCL particle coalescence, higher sinter degree and the dispersion of FU particles in the co-continuous porous PCL matrix. Initially the PCL/FU tablets provided a rapid release of a high concentration of the drug at the site of the cancer cells and a subsequent controlled release sustaining levels of the chemotherapeutic agent in the region of the tumor. This 2-stage release of the drug can be a desirable profile in cartilage cancer treatment.

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“…High percentages of bad response to neoadjuvant chemotherapy are corresponding with results published in some other studies. 2,7 Two patients (2/8), or 25%, survived more than 5 years, and up to date they are disease-free. Function after limb-salvage procedures in our study varied from 23% to 93% (median 59%).…”

Section: Resultsmentioning

confidence: 97%

“…There are very few published data on the survival, efficacy and role of chemotherapy of high-grade chondrosarcoma patients. 6,7 This facts were the motives for this study, and the aim was to analyse the chemotherapy protocol and various limb-salvage surgical techniques in correlation to survival of patients and function of spared limbs.…”

Section: Diagnostic Procedures and Treatmentmentioning

confidence: 99%