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Childhood Osteosarcoma Treatment

Our treatment approach

Osteosarcoma, or bone cancer, is rare, and most oncologists have little experience treating it. Children’s Cancer Hospital physicians treat a high number of patients with osteosarcoma, which translates to a remarkable level of skill and expertise.

Since osteosarcoma usually requires multiple treatments, a comprehensive, personalized team approach is crucial. At the Children’s Cancer Hospital, your child is the focus of a multidisciplinary group of specialized physicians, including surgeons, oncologists, radiation oncologists and pathologists, who are with your child throughout treatment. They are supported by highly trained rehabilitation specialists, therapists, nurses and other health care professionals who work together to ensure your child receives the best care.

Advanced expertise

In most osteosarcoma cases, very small areas of cancer have spread to other parts of the body. They are called micrometastases. These areas usually do not show up in imaging tests. For that reason, chemotherapy, which travels to all parts of the body, is almost always the first treatment for osteosarcoma. Chemotherapy is almost always given after surgery as well.

Osteosarcoma treatment almost always includes surgery. Children’s Cancer Hospital surgeons are among the most skilled in the nation. They use the most up-to-date techniques and technologies, including limb-sparing surgeries, so most patients can avoid the loss of an arm or leg. If limb-sparing surgery is not an option, Children’s Cancer Hospital offers the most advanced prostheses, with specialized pediatric rehabilitation services.

Groundbreaking research

Many children with osteosarcoma are treated with innovative agents through clinical trials. The Children’s Cancer Hospital participates in Children’s Oncology Group protocols, as well as other clinical trials available at only a few hospitals in the nation.

Our osteosarcoma treatments

If your child is diagnosed with osteosarcoma, the doctor will discuss the best treatment options. This depends on several factors, including the size and location of the cancer, if it has spread, and your child’s age and general health.

Osteosarcoma usually is treated with a combination of therapies that may include surgery, chemotherapy and radiation. Surgery is almost always part of treatment.

The experts at Children’s Cancer hospital will customize a course of treatment especially for your child’s needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.


At Children’s Cancer Hospital, our specialized orthopedic surgeons are often able to avoid amputation when osteosarcoma is in an arm or leg. Complex limb-sparing surgery removes the tumor, but saves the tendons, nerves and blood vessels. Bone is replaced with a bone graft or an internal prosthesis, similar to an artificial joint.

Like all surgeries, osteosarcoma surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. MD Anderson surgeons are among the most skilled and recognized in the world. They among the few surgeons in the world who specialize in pediatric sarcoma treatment, and they use the least-invasive and most advanced methods.

Whenever possible, the biopsy and surgical treatment should be planned together.


Chemotherapy for osteosarcoma is usually given before (neoadjuvant chemotherapy) and after surgery (adjuvant chemotherapy).

Children’s Cancer Hospital offers the most up-to-date and advanced chemotherapy options.

Radiation therapy

Radiation therapy (also called radiotherapy) uses high-energy beams to destroy cancer cells. Osteosarcoma cells do not respond well to radiation, so it is not a main part of treatment for most cases. It may be used if the tumor cannot be completely removed by surgery or to help control symptoms.

If radiation is needed, new radiation therapy techniques allow Children’s Cancer Hospital doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.

Children’s Cancer Hospital provides leading-edge radiation treatments, including 3D-conformal radiation therapy and intensity-modulated radiotherapy (IMRT), which are tailored to the specific shape of the tumor.

Proton therapy

The Proton Therapy Center at MD Anderson is one of the world’s largest and most advanced centers. It’s the only proton therapy facility in the country located within a comprehensive cancer center. This means this cutting-edge therapy is backed by all the expertise and compassionate care for which MD Anderson is famous.

Proton therapy delivers high radiation doses directly into the tumor, sparing nearby healthy tissue and vital organs. For many patients, this results in better cancer control with less impact on the body.

Radioactive drugs (radiopharmaceuticals)

Targeted therapies

Children’s Cancer Hospital is leading into the future of cancer treatment by developing innovative targeted therapies. These agents are specially designed to treat each cancer’s specific genetic/molecular profile to help the body fight the disease. Many of the doctors who treat osteosarcoma, or bone cancer, at Children’s Cancer Hospital are dedicated researchers who have pioneered and actively lead national and international clinical trials with novel targeted agents.

Treatment at MD Anderson

Childhood osteosarcoma is treated in our Children's Cancer Hospital.

Clinical Trials

MD Anderson patients have access to clinical trials offering promising new treatments that cannot be found anywhere else.

Knowledge Center

Find the latest news and information about childhood osteosarcoma in our Knowledge Center, including blog posts, articles, videos, news releases and more.


MD Anderson has licensed social workers to help patients and their loved ones cope with cancer.


Talk to someone who shares your cancer diagnosis and be matched with a survivor.

Prevention and Screening

Many cancers can be prevented with lifestyle changes and regular screening.