Pain control
Limb sparing surgery or amputation, if needed
Depends on location and extent of the primary tumor
Neoadjuvant chemotherapy
Response is a major prognostic factor
MAP therapy (methotrexate, doxorubicin, cisplatin) often regimen of choice for non-metastatic disease
No standard approach if metastatic
Typically, radiation resistant
If at base of skull or sacrum can consider intensity-modulated radiation therapy
Depends on location and extent of the primary tumor
Response is a major prognostic factor
No standard approach if metastatic
If at base of skull or sacrum can consider intensity-modulated radiation therapy
Osteosarcoma
Multiple myeloma
Ewing sarcoma
Chondrosarcoma
Paget disease
Myositis ossificans
Osteomyelitis
Adamantinoma