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Osteogenic Sarcoma of the Head and Neck: Is Chemotherapy Needed?

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Opinion statement

Head and neck osteosarcoma (HNOS) is a rare subtype of sarcoma that most commonly arises in the mandible or maxilla. Treatment for HNOS typically involves a multidisciplinary and multimodal approach depending on the size, grade, and histological subtype. Surgery by sarcoma-experienced head and neck surgeons and orthopedic oncologists remains a crucial component of treatment in all subtypes of HNOS, particularly for those with low-grade histology, which can be treated definitively with surgical resection if negative margins are obtained. Negative surgical margins are of utmost prognostic importance, and neoadjuvant or adjuvant radiation should be considered in patients with positive (or anticipated positive) margins/residual postoperative disease. Current data favors the use of (neo)adjuvant chemotherapy in patients with high-grade HNOS to improve overall survival but must be individualized to weigh benefits and risks of the short- and long-term effects of treatment. Our center uses a multidisciplinary treatment plan and notes anecdotal improvement in treatment outcomes with a combined surgical and ifosfamide-containing chemotherapeutic approach with radiotherapy for local control if positive margins. Large volume cohorts and adequate randomized control trials assessing the efficacy of chemotherapy in HNOS are scant and additional research and multi-institutional collaboration are needed to study polychemotherapeutic and radiation treatment regimens and outcomes more adequately.

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  1. Sylvester Comprehensive Cancer Center/University of Miami, 1611 NW 12th Ave, ACC East-1st Floor, Miami, FL, USA

    Steven Bialick DO, MS, Leticia Campoverde MD, Jesus Antonio Ocejo Gallegos MD, Priscila Barreto-Coelho MD, Aleksandra Watson PharmD, Kshitij Arora MBBS, Shree Venkat MD, Andrew E. Rosenberg MD, Brooke Crawford MD, Emily Jonczak MD, Jonathan Trent MD, PhD, Aditi Dhir MD & Gina D’Amato MD

  2. Miller School of Medicine, University of Miami, Miami, FL, USA

    Andres Perez BA & Esdras Lopez BS

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Bialick, S., Campoverde, L., Gallegos, J.A.O. et al. Osteogenic Sarcoma of the Head and Neck: Is Chemotherapy Needed?. Curr. Treat. Options in Oncol. 24, 528–541 (2023). https://doi.org/10.1007/s11864-023-01073-4

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