There is a real possibility of side effects when chemotherapy is administered preoperatively. Therefore when high-dose chemotherapy is administered, it needs to be guided by experienced doctors and nurses for adjuvant and supportive treatment. Otherwise, many patients will not be able to tolerate the side effects of chemotherapy and are likely to terminate halfway through chemotherapy or fail to complete the entire chemotherapy program. As for whether surgery can be performed directly when side effects are not tolerated, it needs to be evaluated. It is important to know that X-rays and MRI must be done before surgery for osteosarcoma to evaluate the effect of chemotherapy, and only if the chemotherapy is effective can surgery be performed. Therefore, it is recommended to try to complete the planned chemotherapy treatment course before surgery. Neoadjuvant chemotherapy for osteosarcoma is internationally recognized, however, the neoadjuvant chemotherapy regimens performed in major hospitals across the country are different, including the dose of drugs and the combination of drugs administered. Currently, most hospitals use sequential dosing, which is administered every two weeks. According to the T-series regimen in the United States, it is more reasonable if it is performed 12 to 14 times. However, Chinese people do not fully tolerate this regimen, so relatively speaking, the duration of chemotherapy needs to be prolonged and the efficacy is a little bit worse. In addition, in neoadjuvant chemotherapy, the chemotherapy regimen of giving three drugs for five days has the advantage of concentrated dosing and high dose to kill tumor cells; the disadvantage is that it is risky and requires a higher level of patient’s own condition as well as supportive treatment.