Treatments for chondrosarcoma

The following are treatment options for chondrosarcoma. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery is the main treatment for most types of chondrosarcoma. It may be used for tumours that are newly diagnosed and tumours that have come back (recurred). The following types of surgery may be used.

Wide resection removes the bone tumour and a small amount of tissue and bone around it (called a surgical margin). Doctors may use other terms for wide resection, such as en bloc resection or wide excision.

Wide resection is the most common surgical method used for chondrosarcoma. It is used to treat high-grade chondrosarcoma in the bones of the skull, spine (vertebrae), arms, legs or pelvis (hip). It may also be used to treat an atypical cartilaginous tumour (also called low-grade chondrosarcoma) in the pelvis, shoulder blades, ribs or spine.

Limb-sparing surgery is often used to remove tumours in an arm or a leg. During limb-sparing surgery, surgeons do a wide resection to remove the tumour without amputating the limb.

Reconstructive surgery is done at the same time as surgery to remove the tumour. Bone and tissue grafts may be used to replace tissues removed during surgery. A joint removed with surgery may be replaced with a metallic artificial joint (endoprosthesis).

Curettage is a procedure that uses a spoon-shaped tool with a sharp edge (called a curette) to scrape a tumour out of the bone. This leaves a hole where the tumour was removed.

After curettage, the surgeon may use bone cement to fix the hole left in the bone and destroy any remaining cancer cells. Bone cement is a chemical called polymethyl methacrylate. This special cement heats up as it hardens, so it can kill any remaining cancer cells in the bone.

Curettage is used to treat atypical cartilaginous tumour (also called low-grade chondrosarcoma) in the bones of the leg or arm.

Amputation removes all or part of the arm or leg with the tumour. It may be done when a chondrosarcoma has grown into the nerves or blood vessels or if the tumour is very big. Amputation may also be done if the cancer comes back in the same area after limb-sparing surgery. Most people who have an amputation will use an artificial limb (prosthesis) after surgery.

Find out more about surgery for bone cancer.

Chemotherapy uses drugs to destroy cancer cells. It is sometimes offered for chondrosarcoma.

Mesenchymal chondrosarcoma may be treated with adjuvant chemotherapy after surgery. The chemotherapy drug combinations that are used include:

• VDC/IE – vincristine, doxorubicin and cyclophosphamide, alternated with ifosfamide and etoposide
• vincristine, doxorubicin, ifosfamide and dactinomycin
• MAP – methotrexate, doxorubicin and cisplatin

If mesenchymal chondrosarcoma has already metastasized at the time of the diagnosis, the following drug combinations may be used:

• vincristine, doxorubicin and cyclophosphamide
• gemcitabine and docetaxel
• cyclophosphamide and topotecan

Dedifferentiated chondrosarcoma may be treated with the same chemotherapy drug combinations that are used for osteosarcoma.

Find out more about chemotherapy for bone cancer.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is not often used for chondrosarcoma.

External radiation therapy may be used to:

• treat chondrosarcoma that can’t be removed with surgery
• destroy any cancer cells left behind after surgery
• treat pain and control the symptoms of chondrosarcoma that has spread (metastasized) or recurred (called palliative therapy)

Find out more about radiation therapy for bone cancer.

Talk to your doctor about clinical trials open to people with bone cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.