clinical pathway of cancer - osteosarcoma

Osteosarcoma, a primary bone cancer, is predominantly diagnosed in adolescents and young adults. Despite advancements in treatment, prognosis remains challenging, emphasizing the need for standardized and effective clinical pathways. This review aims to outline a comprehensive clinical pathway for osteosarcoma management, encompassing diagnosis, staging, treatment, follow-up, and supportive care. Early detection is crucial for optimal outcomes. Clinical suspicion arises from bone pain, swelling, and a palpable mass. Radiographic imaging (X-ray, CT, MRI) is essential for diagnosis and assessment of tumor extent. Histological confirmation is obtained through biopsy. Staging is performed using the Enneking system, which classifies tumors based on their size, grade, and metastatic status. The treatment approach depends on the stage of the disease and patient factors. For localized osteosarcoma, surgery is the primary modality. Limb-salvage procedures, such as wide resection followed by reconstruction, are preferred when feasible. For metastatic disease, neoadjuvant chemotherapy is often administered to reduce tumor burden before surgery. Adjuvant chemotherapy is then used to eradicate micrometastases. Radiation therapy is rarely used as a primary treatment but may be considered for palliation or in specific cases. Close surveillance is critical after treatment to detect recurrence or metastatic disease. Regular follow-up includes clinical examinations, radiographic imaging, and tumor marker monitoring. Early detection of recurrence allows for timely intervention, potentially improving outcomes. Osteosarcoma treatment can have significant physical and psychological effects on patients and their families. Supportive care services, including pain management, rehabilitation, psychosocial counseling, and nutritional support, are essential to improve quality of life and facilitate recovery. Despite progress, several challenges persist in osteosarcoma management. Heterogeneity of the disease, late diagnosis, and treatment-related side effects are key obstacles. Ongoing research focuses on developing novel targeted therapies, immunotherapy, and personalized treatment approaches. Additionally, efforts are underway to improve early detection through advanced imaging techniques and biomarkers. In conclusion, a well-defined clinical pathway for osteosarcoma is essential for optimizing patient care. This pathway encompasses diagnosis, staging, treatment, follow-up, and supportive care. By addressing the unique challenges associated with this disease, future advancements in research and clinical practice may lead to improved outcomes for patients with osteosarcoma.

کلیدواژه ها:

osteosarcoma ، clinical pathway ، diagnosis ، targeted therapy ، immunotherapy