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A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice

SIMPLE SUMMARY: Patients with femoral metastases are at risk of developing a fracture, whose prevention is important for maintaining mobility and, hence, patients’ quality of life. The BOne Strength (BOS) score is a computed tomography (CT)-based patient-specific computer model that objectively calc...

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Autores principales: Eggermont, Florieke, van der Linden, Yvette, Verdonschot, Nico, Dierselhuis, Edwin, Ligthert, Steven, Bitter, Thom, Westhoff, Paulien, Tanck, Esther
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740241/
https://www.ncbi.nlm.nih.gov/pubmed/36497388
http://dx.doi.org/10.3390/cancers14235904
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author Eggermont, Florieke
van der Linden, Yvette
Verdonschot, Nico
Dierselhuis, Edwin
Ligthert, Steven
Bitter, Thom
Westhoff, Paulien
Tanck, Esther
author_facet Eggermont, Florieke
van der Linden, Yvette
Verdonschot, Nico
Dierselhuis, Edwin
Ligthert, Steven
Bitter, Thom
Westhoff, Paulien
Tanck, Esther
author_sort Eggermont, Florieke
collection PubMed
description SIMPLE SUMMARY: Patients with femoral metastases are at risk of developing a fracture, whose prevention is important for maintaining mobility and, hence, patients’ quality of life. The BOne Strength (BOS) score is a computed tomography (CT)-based patient-specific computer model that objectively calculates the bone strength of femurs with metastases. It was developed to aid patients and their treating physicians in selecting appropriate treatment options, either radiotherapy in low-risk femurs or elective stabilizing surgery in high-risk femurs. In this pilot study, the added clinical value of the BOS score in treatment-related decision making was assessed. The study showed that the BOS score is a promising and objective tool to assess fracture risk in femoral bone metastases and aids physicians and patients in making a more informed decision regarding the most appropriate treatment. ABSTRACT: Patients with femoral metastases are at risk of fracturing bones. It is important to prevent fractures in order to maintain mobility and quality of life. The BOne Strength (BOS) score is based on a computed tomography (CT)-based patient-specific finite element (FE) computer model that objectively calculates bone strength. In this pilot study, the added clinical value of the BOS score towards treatment-related decision making was assessed. In December 2019, the BOS score was implemented in four radiotherapy centers. The BOS scores and fracture risks of individual patients were calculated and returned to the physician to assist in treatment decisions. The physicians filled out a questionnaire, which was qualitatively analyzed. A follow-up to identify fractures and/or death was performed after six months. Until June 2021, 42 BOS scores were delivered (20 high, 9 moderate, and 13 low fracture risk). In 48%, the BOS score led to an adaptation of treatment plans. Physicians indicated that the BOS score provided objective insight into fracture risk, was reassuring for physicians and patients, and improved multidisciplinary discussions and shared decision making. In conclusion, the BOS score is an objective tool to assess fracture risk in femoral bone metastases and aids physicians and patients in making a more informed decision regarding the most appropriate treatment.
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spelling pubmed-97402412022-12-11 A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice Eggermont, Florieke van der Linden, Yvette Verdonschot, Nico Dierselhuis, Edwin Ligthert, Steven Bitter, Thom Westhoff, Paulien Tanck, Esther Cancers (Basel) Article SIMPLE SUMMARY: Patients with femoral metastases are at risk of developing a fracture, whose prevention is important for maintaining mobility and, hence, patients’ quality of life. The BOne Strength (BOS) score is a computed tomography (CT)-based patient-specific computer model that objectively calculates the bone strength of femurs with metastases. It was developed to aid patients and their treating physicians in selecting appropriate treatment options, either radiotherapy in low-risk femurs or elective stabilizing surgery in high-risk femurs. In this pilot study, the added clinical value of the BOS score in treatment-related decision making was assessed. The study showed that the BOS score is a promising and objective tool to assess fracture risk in femoral bone metastases and aids physicians and patients in making a more informed decision regarding the most appropriate treatment. ABSTRACT: Patients with femoral metastases are at risk of fracturing bones. It is important to prevent fractures in order to maintain mobility and quality of life. The BOne Strength (BOS) score is based on a computed tomography (CT)-based patient-specific finite element (FE) computer model that objectively calculates bone strength. In this pilot study, the added clinical value of the BOS score towards treatment-related decision making was assessed. In December 2019, the BOS score was implemented in four radiotherapy centers. The BOS scores and fracture risks of individual patients were calculated and returned to the physician to assist in treatment decisions. The physicians filled out a questionnaire, which was qualitatively analyzed. A follow-up to identify fractures and/or death was performed after six months. Until June 2021, 42 BOS scores were delivered (20 high, 9 moderate, and 13 low fracture risk). In 48%, the BOS score led to an adaptation of treatment plans. Physicians indicated that the BOS score provided objective insight into fracture risk, was reassuring for physicians and patients, and improved multidisciplinary discussions and shared decision making. In conclusion, the BOS score is an objective tool to assess fracture risk in femoral bone metastases and aids physicians and patients in making a more informed decision regarding the most appropriate treatment. MDPI 2022-11-29 /pmc/articles/PMC9740241/ /pubmed/36497388 http://dx.doi.org/10.3390/cancers14235904 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Eggermont, Florieke
van der Linden, Yvette
Verdonschot, Nico
Dierselhuis, Edwin
Ligthert, Steven
Bitter, Thom
Westhoff, Paulien
Tanck, Esther
A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice
title A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice
title_full A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice
title_fullStr A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice
title_full_unstemmed A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice
title_short A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice
title_sort patient-specific fracture risk assessment tool for femoral bone metastases: using the bone strength (bos) score in clinical practice
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740241/
https://www.ncbi.nlm.nih.gov/pubmed/36497388
http://dx.doi.org/10.3390/cancers14235904
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