Mailankody Sharada, Kumar Venkatesan Sampath, Khan Shah Alam, Banavali Shripad D, Bajpai Jyoti
Department of Medical Oncology, Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Karnataka, India.
Manipal Academy of Higher Education, Manipal, Karnataka, India.
Pediatr Blood Cancer. 2022 Mar;69(3):e29540. doi: 10.1002/pbc.29540. Epub 2021 Dec 31.
Osteosarcoma is a rare malignancy; however, it is still the most common primary bone tumor in adolescents and young adults. Chemotherapy improves survival indubitably in osteosarcoma; nevertheless, the concern is the stagnant progress since the last several decades. There are a handful of active agents and unresolved issues, especially in choosing the ideal chemotherapy regimen. The oncology community is in equipoise regarding the position of high-dose methotrexate (HDMTX), mandatory or adjunct. The choice of therapy becomes widely relevant, including in low- and middle-income countries (LMIC), where HDMTX administration brings additional complexities. Research into novel non-HDMTX-based protocols adapted to the available resources is pivotal in improving disease outcomes, especially in LMIC. The current review focuses on real-world challenges in decision-making and provides a comprehensive overview of the evolution of treatment protocols in LMIC.
骨肉瘤是一种罕见的恶性肿瘤；然而，它仍是青少年和年轻成年人中最常见的原发性骨肿瘤。化疗无疑提高了骨肉瘤患者的生存率；尽管如此，令人担忧的是过去几十年来进展停滞不前。有一些有效的药物和尚未解决的问题，尤其是在选择理想的化疗方案方面。肿瘤学界对于大剂量甲氨蝶呤（HDMTX）是必需的还是辅助性的存在分歧。治疗方案的选择具有广泛的相关性，在低收入和中等收入国家（LMIC）也是如此，在这些国家使用HDMTX会带来更多复杂性。研究适用于现有资源的新型非HDMTX方案对于改善疾病治疗结果至关重要，尤其是在LMIC。本综述聚焦于决策中的实际挑战，并全面概述了LMIC治疗方案的演变。
