The information here focuses on primary bone cancers (cancers that start in bones) that most often are seen in adults. Information on Osteosarcoma, Ewing Tumors (Ewing sarcomas), and Bone Metastasis is covered separately.
Chemotherapy (chemo) is the use of drugs to treat cancer. These drugs are usually given into a vein (IV) and can reach and destroy cancer cells anywhere in the body, so chemo is most likely to be useful for cancers that have spread to other organs.
Chemo is often an important part of treatment for Ewing sarcoma, osteosarcoma, and undifferentiated pleomorphic sarcoma (UPS). But it's used less often for most other types of bone cancers, like giant cell tumors and most types of chordomas and chondrosarcomas. These types aren’t very sensitive to chemo, so other medicines might be tried first instead.
Some of the chemo drugs that can be used to treat bone cancer include:
In most cases, 2 or more drugs are given together.
Chemo kills cancer cells, but it also damages some normal cells, which can lead to side effects. These depend on the type of drugs and doses used, and the length of time they're taken.
Some common short-term side effects can include:
Chemo can damage the bone marrow, where new blood cells are made. This can lead to low blood cell counts, which can result in:
While you're getting chemo, your doctor will order lab tests to be sure your blood cell counts are at safe levels.
Some side effects are linked to certain drugs. For example:
It’s important to note that many of the serious side effects are uncommon, but they can happen. Talk with your cancer care team so you know what to expect from the chemo you're getting.
The doctors and nurses will watch you closely for side effects. Most side effects tend to go away in time after treatment is over. Still, it's important to tell your cancer care team about any side effects you have so they can be treated. Be sure to discuss any questions you have about side effects with the cancer care team, and tell them about any side effects so that they can be controlled.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Anderson ME, Dubois SG, Gebhart MC. Chapter 89: Sarcomas of bone. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.
Gelderblom AJ, Bovee JV. Chondrosarcoma. UpToDate. 2020. Accessed at https://www.uptodate.com/contents/chondrosarcoma on September 11, 2020.
Benjamin RS, Wagner MJ, Livingston JA, Ravi V, Patel SR. Chemotherapy for bone sarcomas in adults: The MD Anderson experience. Am Soc Clin Oncol Educ Book. 2015:e656-e660.
Gutowski CJ, Basu-Mallick A, Abraham JA. Management of bone sarcoma. Surg Clin N Am. 2016;2016:1077–1106.
Hornicek FJ, Agaram N. Bone sarcomas: Preoperative evaluation, histologic classification, and principles of surgical management. UpToDate. 2020. Accessed at https://www.uptodate.com/contents/bone-sarcomas-preoperative-evaluation-histologic-classification-and-principles-of-surgical-management on September 11, 2020.
National Cancer Institute. Osteosarcoma and Malignant Fibrous Histiocytoma of Bone Treatment (PDQ®)–Health Professional Version. 2020. Accessed at https://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq on September 11, 2020.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Bone Cancer. Version 1.2020. Accessed at www.nccn.org/professionals/physician_gls/pdf/bone.pdf on September 11, 2020.
Last Revised: June 17, 2021