Post-treatment late and long-term effects in bone sarcoma: A scoping review

Area of Science:

• Oncology
• Survivorship Care
• Medical Research

Background:

• Bone sarcomas (e.g., Ewing sarcoma, osteosarcoma) treatments (chemotherapy, surgery, radiotherapy) have significant toxicities and life-altering consequences.
• Post-treatment follow-up for late and long-term effects beyond oncological surveillance is inconsistently provided to former patients.
• Anecdotal evidence suggests many bone sarcoma survivors face late effects with limited support due to variable follow-up care.

Purpose of the Study:

• To conduct a scoping review to empirically identify knowledge gaps in late and long-term effects of bone sarcoma treatment.
• To provide an overview of peer-reviewed literature reporting on the late and long-term effects experienced by bone sarcoma survivors.

Main Methods:

• A scoping review was performed following JBI Scoping Review Network guidelines.
• Extensive literature searches were conducted across multiple databases (Medline, Cochrane, EMBASE, CINAHL, PsycINFO, Proquest, Web of Science).
• Seventy-four peer-reviewed articles, primarily retrospective studies with up to 20 years of follow-up, were included.

Main Results:

• Major physical late and long-term effects identified include secondary malignancies, cardio- and nephrotoxicity, reduced bone mineral density, and motor neuropathies.
• Cancer-related fatigue was also noted as a significant long-term effect requiring attention.
• Follow-up care may need to extend over decades, particularly with a growing population of survivors.

Conclusions:

• There is a critical need for dedicated follow-up services to manage the diverse late and long-term effects of bone sarcoma treatment.
• The findings provide an evidence base for future service mapping and expanded clinical recommendations for survivorship care.
• Addressing these long-term effects is crucial for improving the quality of life for bone sarcoma survivors.