Journal of Orthopedic Oncology
Open Access

Bone tumor; X-rays; Chemotherapy; Drug delivery; Radiopharmaceutical

Malignant tumors that occur in tissues such as bone, cartilage, and muscle are called sarcomas. Osteosarcoma (OS), the most common type of primary malignant bone tumor, is defined by the presence of malignant mesenchymal cells that produce osteoid or immature bone. It accounts for 30-80% of primary skeletal sarcomas and is the most common malignant bone disease [1]. The population affected is predominantly children, teenagers, and young adults aged 10–30 years [2]. Men are more affected than women. The highest incidence of the most common types of OS, i. H. High-grade central OS occurs 20 years after adolescent growth. If left untreated, OS can become unforgiving due to the progression of local and systemic disease and death within a few months. Outcomes for OS patients were poor before the use of effective chemotherapy, with a 2-year overall survival of 15% to 20% after surgical resection and / or radiation therapy [3].

In general, bone tumors in children are rare, with an estimated 8.7 per million children under the age of 20 [4], this represents 650-700 new osteosarcoma patients annually. OS has a bimodal age distribution, the first peak in 20 years of life (during adolescent growth surge; most frequent ages: 16 years for girls, 18 years for boys) and second for the elderly There is a peak. Boys are said to be affected more often in most series, and African-American children have a slightly higher incidence of OS than whites very rare under the age of five. At the first diagnosis, 15-20% of patients have overt lung metastases, but 40% of patients develop metastases at a later stage. Based on the clinical outcome of patients with no apparent metastases at diagnosis during the prechemotherapy period, approximately 90% of patients developed lung metastases 6-36 months later. The vast majority of apparently nonmetastatic patients are believed to actually have micrometastatic disease at the time of diagnosis. It occurs more frequently in the metaphyseal region of the tubular long bone, 42% in the femur, 19% in the tibia, and 10% in the humerus. Approximately 8% of all cases occur in the skull and chin, and an additional 8% occur in the pelvis [4].

Pathology

OS preference for adolescent growth spurt age and site of maximal growth suggests a correlation with rapid bone growth. A minority of operating systems are caused by exposure to radiation. Radiationrelated cases are more common in adults because it takes about 10 to 20 years for OS to develop from radiation therapy. Exposure to alkylating agents may also contribute to OS development [5]. However, the majority of OS occurs in patients with unknown germline abnormalities. Various serological markers are associated with pediatric OS. These can be broadly divided into several groups. Markers are most commonly grouped by chemical structure or biological function within an organism [6, 7, 8]. Chemically, markers can be classified as glycoproteins, polypeptides, carbohydrate determinants of glycoproteins, glycolipids, proteins, polyamines, and immunoglobulins [9, 10, 11, 12].

High-grade OS is most likely derived from mesenchymal stem cells that are at least partially attached to the osteoblast lineage, but the exact origin of the cells is unknown. Patients with hereditary retinoblastoma, Rothmund-Thomson syndrome, Li-Fraumeni syndrome, and Werner syndrome are predisposed to develop OS and genes associated with these diseases (RB1, RECQL4, TP53, and Changes in WRN) are the etiology of OS [13].

In terms of biological function, markers can be divided into oncofetal antigens, enzymes, hormones, receptors, and compounds with a yet unclear function [14, 15, 16]. Tumor markers involved in angiogenesis, cell adhesion, apoptosis, and the cell cycle have been shown recently to play an important role in OS growth, differentiation, and metastasis [17, 18, 19, 20]. Over the coming years, the new markers may be able to prognosticate pediatric OS patients at baseline as well as to serve as therapeutic targets and thereby further improve survival rates [21, 22, 23]. No OS-specific marker, more particularly pediatric OS-specific marker, has been found thus far, so where lies the future of pediatric OS biomarker research? At the cytogenetic level, OSs have highly complex karyotypes with many numerical and structural abnormalities; a consistent cytogenetic abnormality has not been identified [24]. Three major subtypes of conventional OS are recognized: Osteoblastic, chondroblastic, and fibroblastic reflecting the predominant form of tumor matrix.Treatment and outcome of these subtypes are not different. Parosteal OS, central low-grade OS, and periosteal OS are morphologically and clinically distinct OS subtypes with an improved prognosis and constitute <5% of cases of OS.

Osteosarcoma is most common in children aged 10 to 20 and young adults and often occurs during the growing season. It occurs more often in boys than in girls. Osteosarcoma is osteosarcoma. That is, osteosarcoma can spread to other organs and tissues in the body, most commonly starting in the lungs. The cause of osteosarcoma is unknown, but genetics may play an important role. Symptoms of osteosarcoma depend on the size and location of the bone tumor and the age and general health of the child. Symptoms include:

• Tumor site pain, stiffness, or tenderness

• Pain gradually worsens over time and may spread radially outward from the tumor site.

• Pain that awakens a child from a deep sleep

• Swelling or mass around the affected bone

• Poor athletic performance. Including difficulty walking and dragging

• Weak bones that can lead to fractures

• Malaise

• Weight loss

• Anemia

Osteosarcoma near the spinal cord can cause back pain that spreads to the arms and legs. Many symptoms of osteosarcoma can easily be ignored as normal growth pain in children, and regular examination and referral to a specialist are very important. Prompt diagnosis and identification of cancer is important for successful treatment. Use of various diagnostic tests to diagnose tumors, including:

• X-rays that produce images of bones.

• Magnetic resonance imaging (MRI). Use a combination of large magnets, radio frequencies, and computers to create detailed images of organs, soft tissues, muscles, ligaments, and other internal structures. Your child will not be exposed to radiation during MRI.

• Computer tomography (CT) scans. It uses a combination of x-rays and computer techniques to examine other areas such as bones and lungs and create cross-sectional images (“slices”) of the body.

• EOS Imaging is an image technology that creates a 3D model from two flat images. Unlike CT scans, EOS images are taken with the child upright or upright, which improves diagnosis because they are in a weight-bearing position.

• Bone scintigraphy with radioisotopes. Helps identify areas of abnormal growth.

• Positron emission tomography (PET) scan. This involves injecting radioactive sugar into veins and scanners to create detailed computerized images of areas of the body.

• Blood test. This helps determine the use and efficacy of medicines, biochemical disorders, and organ functions.

• Needle biopsy. A procedure in which a doctor inserts a small needle through the skin into a lesion to take a small sample of abnormal tissue. Analyze the tissue to confirm the diagnosis.

This test not only helps diagnose a particular type of cancer, but also helps determine the size and location of the tumor and the stage of the cancer. There are many treatment options for bone and soft tissue cancer. Some children need a combination of these treatments. Treatment of osteosarcoma always includes chemotherapy. Chemotherapy is a drug that helps fight cancer. The drug can be given pre-surgery, post-surgery, or both. This helps to attack not only the primary tumor, but also cancer cells that may have already spread but are not yet recognized. Surgery also has two goals for surgery in the treatment of osteosarcoma. To remove the tumor and restore the function of the tumor site. Approximately 90% of children with osteosarcoma can be treated with limb-sparing (also known as limbsparing) and reconstructive surgery.

In rare cases, radiation therapy may be an option for treating osteosarcoma. Radiation therapy uses high-energy waves, such as x-rays, to kill or shrink cancer cells.

Increasing the understanding of the basic biology of OS has been a high priority in recent years. Since therapy intensification after a poor histologic response has not generally resulted in improved outcome and the prognostic factors available are limited, efforts are directed at identifying biological factors that predict the outcome. Examples include studies of P-glycoprotein expression, DNA ploidy, human epidermal growth factor receptor 2 overexpression, cDNA expression profiling, and comparative genomic hybridization. Many molecular markers are also currently under study, but sufficient data have not yet been accrued to allow any to be recommended as prognostic factors.

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