The new unit of Medical Oncology at the Rizzoli Hospital (called “Osteo-oncology, Bone and Soft Tissue Sarcomas, and Innovative Therapies”) has strengthened its mission by focusing not only on mono- and multidisciplinary care for patients with sarcomas, bone health and bone metastases, but also on basic and clinical research as well as training. The unit integrates into its staff, in addition to medical and department personnel, dedicated clinical and laboratory researchers.

An important focus of the unit is on integrated therapies in oncology, including palliative care in the early as well as advanced stages of the disease and the management of short- and long-term side effects, given the young age of the patients.

The ward of Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies (OSOTT) has 6 patient rooms with a total of 11 beds. Every room has a bathroom. A companion can remain in the ward with the patient throughout hospitalization. Inside the ward there is a kitchen for in-patients and their companions.

The ward is equipped with a playroom and a study room where the in-patients can follow normal school lessons, from elementary school to high school, thanks to a special school project set up in collaboration between the local education Superindendency, the Ministry of Public Education and the Association for Research and Treatment of Tumors of the Locomotor System. Patients can undergo chemotherapy treatment in hotel comfort in our "Private" Ward. On Monday, Tuesday, Thursday and Friday mornings the chemotherapy clinics are open for preliminary and follow up exams.

In the ward there is a clinical psychology service thanks to the presence, 4 days a week, of 2 psychologists in agreement with the University of Bologna

Clinical practice

The ward of Osteoncology is exclusively devoted to the chemotherapy treatment of primary tumors of the locomotor system and clinical research. These tumors, called sarcomas, are divided into two main groups:

• sarcomas of the soft tissues
• sarcomas of the bone (among the latter ones the most common are osteosarcoma and Ewing's sarcoma).

Another field of interest of the unit is bone health in oncology and bone metastases (both from a clinical and research perspective).

The work of the ward mainly involves patients with primary and localized forms of osteosarcoma and Ewing's sarcoma, but rarer forms of primary tumors of the bone are also treated, such as malignant fibrous histiocytoma, leiomyosarcoma, fibrosarcoma, angiosarcoma, mesenchymal chondrosarcoma, and dedifferentiated forms of chondrosarcoma.

The main age range of the patients treated at our department is 10 - 20 years old (around 70% of the in-patients); but patients under 10 years old and adults are also treated. Patients with metastatic and advanced forms of primary bone tumors are treated by specific protocols.

Chemoterapy is administered according to specific national and international protocols, many of which coordinated by our ward (see the description of the clinical research). 

Research activity

Research activities carried out by specific structures:

• the Pharmacogenomics and pharmacogenetics Research Unit, with the aim of identifying the genetic and molecular bases responsible for the reduced response to chemotherapeutic drugs and involved in the predisposition to develop collateral toxicity effects in osteosarcoma;
• the "Advanced Models and Innovative Therapies (MATI)" unit, with the task of carrying out research activities in the field of Osteo-oncology and Sarcomas, in particular bone health, bone metastases and soft tissue sarcomas;
• the Regenerative Therapies in Oncology (TRO) Unit, with the task of carrying out research in the field of Osteo-oncology.

The Osteo-oncology, Bone and Soft Tissue Sarcomas, and Innovative Therapies Unit has also contributed to the drafting of guidelines, developed by the Italian Sarcoma Group within the framework of the Alliance Against Cancer strategic project:

• Guideline for the treatment of Osteosarcoma, drafted during the consensus event held in Bologna at the Rizzoli Orthopaedic Institute on 30 and 31 March 2009;
• Guideline for the treatment of Ewing's sarcoma, drafted during the consensus event held in Bologna at the Rizzoli Orthopaedic Institute on 22 and 23 September 2010.

Clinical Trials Office

Research also focuses on treatments for primary musculoskeletal tumours, including participation in phase II studies.

Michela Pierini e-mail michela.pierini@ior.it

tel. +39-051-6366668