# BIOMECHANICS OF METASTATIC DEFECTS IN BONE

> **NIH NIH R01** · BETH ISRAEL DEACONESS MEDICAL CENTER · 1993 · $269,938

## Abstract

Improved palliative management of osseous metastatic lesions has resulted
in marked increase both in patient survival times and in the incidence of
pathologic fractures.  The assessment and treatment of established osseous
metastases is thus an increasingly important aspect of the clinical
management of cancer patients.  Unfortunately, only the most qualitative of
clinical guidelines are available for assessing fracture risk associated
with metastatic lesions.  Moreover, guidelines have not been developed for
regions such as the proximal femur and spine where osseous metastases are
most common.  During the previous funding period, we have continued the
development of biomechanical predictors of fracture risk associated with
diaphyseal lesions and extended our combined experimental and analytical
approaches to metastases of the proximal femur and spine.  Among other
findings, these studies show clearly that current clinical guidelines for
prophylactic stabilization of metastatic lesions are inadequate and must be
revised to reflect a more appropriate weighting of pain, functional
requirements and biomechanical factors.  To begin to address these issues,
we also developed and applied new clinical assessment procedures based on
flexural rigidity estimates and three-dimensional reconstructions of
Quantitative Computed Tomography (QCT) scans through the site of the
lesion.  We also initiated a pilot study of patients with metastases to the
femur and spine secondary to breast or prostate cancer being treated by the
Joint Center for Radiotherapy.  In the proposed competitive renewal, we
will focus on developing more reliable fracture risk predictors for the
proximal femur and spine and will extend our pilot study to a
representative sample of patients being treated for metastatic lesions of
the femur and spine.  Under aim 1, we will complete our biomechanical
studies of diaphyseal lesions and extend our analyses of strength
reductions associated with metastases to the proximal femur.  Special
attention will be given to the validation of our fracture risk predictors
using in-vitro tests of cadaver bones with either simulated or actual
metastatic lesions.  We will also explore the use of three-dimensional
reconstructions of QCT data and the generation of patient-specific finite
element models for femoral fracture risk prediction.  Under aim 2, we will
determine the sensitivity of QCT measures of lesion geometries and density
changes in the spine and use these to resolve contradictions regarding the
strength reductions associated with lesions which penetrate the vertebral
cortex.  Under aim 3, we will use QCT scans, biomechanical analyses and
psychometric assessments of pain and function to evaluate the response of
osseous metastases to standard radiotherapy treatment protocols used at the
Joint Centers for Radiation.  Therapy for metastatic lesions of the
proximal femur and spine.  We expect these data to provide more
comprehensive and appropriately weigh...

## Key facts

- **NIH application ID:** 3179869
- **Project number:** 5R01CA040211-08
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **SAM.gov UEI:** C1CPANL3EWK4
- **Principal Investigator:** WILSON C HAYES
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1993
- **Award amount:** $269,938
- **Award type:** 5
- **Project period:** 1985-07-01 → 1995-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3179869

## Citation

> US National Institutes of Health, RePORTER application 3179869, BIOMECHANICS OF METASTATIC DEFECTS IN BONE (5R01CA040211-08). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3179869. Licensed CC0.

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