Radiation-Induced Bone Fragility

People: Shannon Emerzian

The focus of this project is to characterize the cause and extent of long-term musculoskeletal injuries caused by radiation therapy (RT).

As cancer survivorship improves, preventing late treatment-induced complications is becoming a great concern. A common late complication of RT is radiation-induced bone fracture. These skeletal fractures occur at directly irradiated sites, and can result in substantial patient morbidity, loss of independence and increased mortality. For example, the risk of hip fracture in postmenopausal women treated for cervical, rectal and anal cancers is greatly increased five years after RT (Relative Risk: 1.66, 1.65, and 3.14) [1]. Within a year of hip fracture, approximately 20 percent of women from this demographic will die [2].

In an effort to understand the mechanisms driving RT-induced bone fracture, this project explores structural and mechanical alterations to bone following RT. Using a detailed biomechanical analysis with finite element and experimental characterization, we are exploring the alterations to bone strength and structure following RT.

[1] Baxter, N.N., Habermann, E.B., Tepper, J.E., Durham, S.B. and Virnig, B.A., 2005. Risk of pelvic fractures in older women following pelvic irradiation. Jama, 294(20), pp.2587-2593.
[2] Center, J.R., Nguyen, T.V., Schneider, D., Sambrook, P.N. and Eisman, J.A., 1999. Mortality after all major types of osteoporotic fracture in men and women: an observational study. The Lancet, 353(9156), pp.878-882.