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Malignant fibrous histiocytoma (MFH) of bone is a rare tumor of the bone. It may occur following radiation treatments. MFH is generally treated the same as osteosarcoma and appears to have a similar response to treatment.
How MFH is treated
If it is suspected that the problem is osteosarcoma, before the first biopsy, your doctor may recommend a specialist called an orthopedic oncologist.
Three kinds of treatment are used:
In addition to these standard therapies, a treatment called biologic therapy is being tested for localized and metastatic MFH. Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
All patients with localized MFH should have surgery to remove the tumor, if possible. The doctor may remove only the cancer and some of the healthy tissue around the cancer (limb-sparing surgery). When the tumor is in a weight-bearing bone, the bone should be protected during activity to avoid fractures that could prevent limb-sparing surgery. Sometimes all or part of an arm or leg may have to be removed (amputated) to make sure that all of the cancer is taken out. If cancer has spread to lymph nodes, the lymph nodes will be removed (lymph node dissection).
In patients with MFH that has not spread beyond the bone, researchers have found no difference in overall survival whether patients have limb-sparing surgery or whether they have surgery with amputation. When the cancer can be taken out without amputation, artificial devices or bones from other places in the body can be used to replace the bone that was removed. The process of rebuilding (reconstructing) a part of the body changed by previous surgery is called reconstructive surgery. Options for reconstructive surgery in patients with osteosarcoma depend on many factors, including where the tumor is, how large it is, the age of the patient, and how much the patient will continue to grow.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill or put into the body by a needle in a vein or muscle. Chemotherapy is called systemic treatment because the drug enters the blood stream, travels through the body, and can kill cancer cells throughout the body. Chemotherapy with more than one drug is called combination chemotherapy.
Sometimes chemotherapy is injected directly into the area where the cancer is found (regional chemotherapy). In osteosarcoma, surgery is often used to remove the local tumor and chemotherapy is then given to kill any cancer cells that remain in the body. Chemotherapy given after surgery has removed the cancer is called adjuvant chemotherapy. Chemotherapy can also be given before surgery to shrink the cancer so that it can be removed during surgery; this is called neoadjuvant chemotherapy.
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation for osteosarcoma usually comes from a machine outside the body (external radiation therapy).
Treatment for MFH depends on the stage of the disease, where the cancer is found, and the patient’s age and general health.
Source: National Cancer Institute