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Natural History of Kids’ Benign Bone Tumors; Sarcoma Staging; Pathologic Fractures

Almost 20% of asymptomatic children and adolescents had benign bone tumors of the extremities, a review of a longitudinal radiographic collection showed.

Overall, 35 benign tumors were identified in 33 pediatric patients whose median age was 8. The most commonly identified tumor types were non-ossifying fibromas (NOF, 7.5%), enostoses (5.2%), osteochondromas (4.5%), and enchondromas (1.8%).

The findings came from a review of the Brush Inquiry, a collection of 25,555 radiographs and 262 healthy children. The x-rays were all left-sided views of each patient’s upper and lower extremities. The overall incidence of benign tumors in the asymptomatic population was 18.9%, and the median age at detection after a previous negative radiograph was 9 years. NOFs were the only tumor type that resolved over time, Christopher D. Collier, MD, of the University of Chicago, reported during the Musculoskeletal Tumor Society (MSTS) virtual meeting.

“The goal of this study was to give us more accurate information on the overall incidence of these [tumors] and the natural history,” MSTS program co-chair Thomas J. Scharschmidt, MD, of Ohio State University in Columbus, said during a review of selected abstracts. “The impetus for the study is that those of us in the oncology world have a lot of consults for NOFs, osteochondromas, and other things that can cause a lot of anxiety for families. This information provides us with some numbers to be able to counsel families when they are sent to us.”

Following are summaries of two other abstracts from the meeting.

Skeletal Staging in Bone Sarcomas

As many as 35% of patients with bone sarcomas and bony metastases at diagnosis would have gone undetected if staging had included only a CT scan of the lungs, a separate review of 9,855 patients showed.

The analysis of the National Cancer Database included patients with newly diagnosed bone sarcomas during 2010-2015: 4,013 patients with chondrosarcoma, 4,105 with osteosarcoma, and 1,737 with Ewing sarcoma. The data showed that 11.7% of patients had lung metastases and 4.8% had bone metastases at diagnosis. The presence of bone metastases was associated with worse survival in each of the three histologies and in all histologies combined (P<0.01).

The study had its origin in the growing interest in modified staging protocols that challenge the value of skeletal staging, Collier and colleagues noted in a poster presentation. The data showed that lung-only staging would have missed metastatic disease in 16% of patients with osteosarcoma, 25% of those with chondrosarcoma, and 35% of patients with Ewing sarcoma.

“I think we probably routinely get bone staging, more so in our bone sarcomas and soft-tissue sarcomas, but I think this study really highlighted the importance of that as well as the poor outcomes with bone metastases overall across all of these bone sarcomas,” said Scharschmidt.

Pathologic Fracture and Limb Salvage Outcomes

Pathologic fracture did not adversely affect patient or implant survival following limb salvage surgery for osteosarcoma, a review of 304 cases showed.

During a median follow-up of 13 years, 17 (5.6%) patients had a

Antimatter Particles Hold Key In Timely Attack Against Growing Tumors

KEY POINTS

  • A timer invented by experts permits PET scanners to attack  cancer cells in their weakest
  • The invention may pave the way to less invasive radiation treatment for cancer patients
  • Inventors hoped the technology can be made more affordable in a decade

Doctors may soon kill cancer tumors with less invasive side effects of radiation treatment. This is after a team of experts designed a scanner that can time the antimatter particles that are significant in detecting the levels of the oxygen concentration in cancer tissues. For years, medical experts have witnessed how low levels of oxygen prevented the timely killing of rapidly growing cancer cells. 

A team of Japanese atomic physicists and nuclear medicine experts designed a timer that can detect the oxygen concentration of tissues growing throughout ta cancer patient’s body. Specifically, the timer permits the positron emission tomography (PET) scanners to know when to attack the cancer cells in their weakest before they can grow to be more aggressive. 

In a study published in Communications Physics, the team of experts from the University of Tokyo and the National Institute of Radiological Sciences (NIRS) in Japan explained that positrons are the positively charged antimatter particles that are extremely low in mass. With how tiny their sizes are, these antimatter particles pose no risk in medical applications. They produce gamma rays that have shorter wavelengths than the electromagnetic waves from X-rays. 

Treatment tool for colon cancer A cinnamon-derived compound may help treat colorectal cancer, researchers said. Photo: Reuters

“We imagine targeting more intense radiation treatment to the aggressive, low-oxygen concentration areas of a tumor and targeting lower-intensity treatment to other areas of the same tumor to give patients better outcomes and fewer side effects,” Dr. Miwako Takahashi, a nuclear medicine physician from NIRS and co-author of the research, said in a press release.

Detecting the amount of oxygen flow in body tissues could tell doctors when to attack the cancer cells. At present conditions, experts are only able to detect tumors when they already have low levels of oxygen which means they have already developed into a hardened lump of tissues or mass.  

Hence, low oxygen levels in tumors indicate that the cells are already aggressive and have become harder to kill. At this stage as well, cancer cells grow to be more resilient against radiation treatment. 

The experts hoped that in less than a decade, their findings could lead to better and less invasive cancer treatments that could also be available economically.

Dr. Christian Hinrichs (R), an investigator at the National Cancer Institute in immunotherapy for HPV+ cancers, shows a survivor of metastatic cancer the difference between his CT scan showing cancerous tumors and a clean scan after treatment Dr. Christian Hinrichs (R), an investigator at the National Cancer Institute in immunotherapy for HPV+ cancers, shows a survivor of metastatic cancer the difference between his CT scan showing cancerous tumors and a clean scan after treatment Photo: AFP / SAUL LOEB

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