Bone sarcoma

Question 1

name some high grade sarcoma

Answer 1

synovial sarcoma
osteosarcoma
ewings sarcoma
rhabdomyosarcoma

Question 2

common sarcoma of head and neck region

Answer 2

rhabdomyosarcoma (child)
angiosarcoma (elderly)
osteogenic sarcoma (jaw)

Question 3

common skin sarcoma

Answer 3

angiosarcoma
kaposi sarcoma
epithelioid sarcoma
lymphangiosarcoma
dermatofibrosarcoma protuberans

Question 4

sarcoma that rarely metastasize

Answer 4

Well differentiated liposarcoma
well differentiated fibrosarcoma
malignant fibrous histiocytoma
kaposi sarcoma

Question 5

paraneoplastic syndrome of sarcoma

Answer 5

hyperglycemia(RPS)
hypertrophic osteoarthropathy
hypocalcemia
oncogenic osteomalacia

Question 6

common bone sarcoma type

Answer 6

1.chondrogenic:
primary chondrosarcoma
secondary chondrosarcoma
dedifferentiated chondrosarcoma
mesenchymal chondrosarcoma
2. osteogenic
osteosarcoma
parosteal osteogenic sarcoma
3. unknown origin
ewings tumor
malignant GCT
4. fibrogenic
fibrosarcoma
5. notochordal
chordoma

Question 7

preferred chemotherapy for osteosarcoma

Answer 7

preferred:
Cisplatin and doxorubicin
MAP(high dose methotrexate, cisplatin, doxorubicin)
other
doxorubicin, cisplatin, ifosfamide and high dose methotrexate

Question 8

2nd line chemotherapy for osteosarcoma

Answer 8

ifosfamide +-etoposide
regorafenib
sorafenib

Question 9

preferred chemotherapy schedule for ewings sarcoma

Answer 9

VDC/IE
VAIA
VIDE

Question 10

radiotherapy dose for ewings sarcoma

Answer 10

definitive RT:
45 gy than boost upto 55.8 gy
preoperative RT
36-45 gy for initial GTV+ 2cm
post operative RT
R0= 45gy
R1=45 (nccn)
R2= 45–boost upto 55.8gy

Question 11

radiotherapy dose for osteosarcoma

Answer 11

consider RT for positive margin or gross residual disease R2
post op RT: 55 gy
unresectable disease: 66-70 gy

Question 12

Prognostic factors for bone sarcoma

Answer 12

Size and extent of local spread
Grade
Location
Size and three dimensions of tumor size
Stage
Mets site
Histologic response to chemo
Pathological fracture

Question 13

Bone sarcoma RT complication

Answer 13

Acute
skin erythema, discoloration
Pain
Swelling
Late
Abnormal bone and soft tissue growth and development,
permanent weakening of the affected bone,
scoliosis,
decreased range of motion due to fibrosis or joint involve- ment,
vascular changes resulting in greater sensitivity to infection,
fracture,
lymphedema,
skin discoloration or tel- angiectasia,
osteoradionecrosis
2nd malignancy: leukemia