骨肉瘤是最常见且致命的骨肿瘤类型。尽管其他癌症治疗方面取得了进展，但骨肉瘤患者的总体生存率在过去四十年里一直停滞不前。多药耐药性，即肿瘤细胞同时对多种药物产生耐药的能力，仍然是有效化疗的重要障碍。近期的研究表明，非编码RNA能够调控靶基因的表达。有人提出，“竞争性末端RNA”活性在转录组范围内形成了一个大规模的调节网络，在癌症等病理情况中起着重要的作用。大量研究强调循环RNA（circRNAs）和长非编码RNA（lncRNAs）可作为竞争性末端RNA结合到微小RNA（miRNA）位点，从而影响和调控mRNA和靶基因的表达。这些circRNA/lncRNA相关的竞争性末端RNA被认为在癌症的发生和进展中起着重要作用。非编码RNA（ncRNAs）在肿瘤耐药性方面发挥重要作用。然而，在骨肉瘤耐药性的lncRNA/circRNA-miRNA-mRNA竞争性末端RNA网络的分子机制仍不清楚。深入研究骨肉瘤耐药性的分子机制以及阐明有效的干预靶点对于改善骨肉瘤患者的整体复原非常重要。本综述聚焦于循环RNA、长非编码RNA和微小RNA介导的竞争性末端RNA网络在骨肉瘤化疗耐药性中的分子机制。© 2023年，BioMed Central有限公司，Springer Nature的一部分。

Osteosarcoma is the most prevalent and fatal type of bone tumor. Despite advancements in the treatment of other cancers, overall survival rates for patients with osteosarcoma have stagnated over the past four decades Multiple-drug resistance-the capacity of cancer cells to become simultaneously resistant to multiple drugs-remains a significant obstacle to effective chemotherapy. The recent studies have shown that noncoding RNAs can regulate the expression of target genes. It has been proposed that "competing endogenous RNA" activity forms a large-scale regulatory network across the transcriptome, playing important roles in pathological conditions such as cancer. Numerous studies have highlighted that circular RNAs (circRNAs) and long noncoding RNAs (lncRNAs) can bind to microRNA (miRNA) sites as competitive endogenous RNAs, thereby affecting and regulating the expression of mRNAs and target genes. These circRNA/lncRNA-associated competitive endogenous RNAs are hypothesized to play significant roles in cancer initiation and progression. Noncoding RNAs (ncRNAs) play an important role in tumor resistance to chemotherapy. However, the molecular mechanisms of the lncRNA/circRNA-miRNA-mRNA competitive endogenous RNA network in drug resistance of osteosarcoma remain unclear. An in-depth study of the molecular mechanisms of drug resistance in osteosarcoma and the elucidation of effective intervention targets are of great significance for improving the overall recovery of patients with osteosarcoma. This review focuses on the molecular mechanisms underlying chemotherapy resistance in osteosarcoma in circRNA-, lncRNA-, and miRNA-mediated competitive endogenous networks.© 2023. BioMed Central Ltd., part of Springer Nature.