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 make 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 come back (recur). The following types of surgery may be used.

Wide resection removes the bone tumour and a wide margin of normal bone and tissue around the tumour. This type of surgery is also called an en bloc resection. It is the most common type of surgery used for chondrosarcoma. It is used to treat a chondrosarcoma in the bones of the skull or spine, as well as in the arm, leg and pelvis.

Curettage is a procedure where the surgeon scrapes out the tumour without removing any of the bone. This leaves a hole where the tumour was removed. After curettage, the surgeon may use cryosurgery or bone cement to kill any remaining cancer cells.

Bone cement is a type of chemical called polymethyl methacrylate that may be used after curettage to fix the hole left in the bone. This special cement heats up as it hardens, so it kills remaining cancer cells. It may be used after curettage to treat some small, low-grade chondrosarcoma tumours.

Limb-sparing surgery removes the tumour without removing (amputating) the whole arm or leg (the limb). Surgeons remove all of the tumour and any of the soft tissues where the bone cancer has spread. After this type of surgery, the limb is reconstructed using bone and skin grafts. Limb-sparing surgery may be used to treat chondrosarcoma in the arm, leg and pelvis.

Amputation removes all or part of the arm or leg with the tumour. It may be done when the chondrosarcoma has grown into the nerves or blood vessels, or if the tumour is very big. Amputation may 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.

Reconstructive surgery is done at the same time as surgery to remove the tumour. Bone and tissue grafts may be done to replace tissues removed during surgery. An endoprosthesis may be used to replace joints removed with surgery.

External beam radiation therapy may be used to treat chondrosarcoma that can’t be removed with surgery. It may also be used to destroy any cancer cells left behind after a wide resection or limb-sparing surgery. Radiation therapy is also used for recurrent chondrosarcoma.

Conformal proton beam radiation therapy or intensity-modulated radiation therapy (IMRT) may be used for chondrosarcoma tumours found at the base of the skull or in the spinal bones (vertebrae).

Chemotherapy is not used for low-grade chondrosarcoma because it has not been shown to help improve survival.

Dedifferentiated chondrosarcoma may be treated with some of the same chemotherapy drugs that are used for osteosarcoma.

Mesenchymal chondrosarcoma is an aggressive, high-grade type of chondrosarcoma. It may be treated with one of the following combinations of chemotherapy drugs:

• vincristine, doxorubicin and cyclophosphamide (Procytox), alternated with ifosfamide (Ifex) and etoposide (Vepesid)
• vincristine, doxorubicin, ifosfamide and dactinomycin (Cosmegen)

If mesenchymal chondrosarcoma has already spread (metastasized) at the time of the diagnosis, the following drug combination may be used:

• vincristine, doxorubicin and cyclophosphamide

Talk to your doctor about clinical trials for bone cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.