Oncological Engineering - A new concept in the treatment of bone metastases

肿瘤工程——治疗骨转移的新概念

• 批准号: EP/W007096/2
• 负责人: Richard Hall
• 金额: --
• 依托单位: University of Birmingham
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FW007096%2F2
• 关键词: Oncological; Engineering; new; concept; treatment

Approximately 2 million people are living with cancer in the UK and this number is set to rise considerably over the next decade to 3.2M. A significant complication of late stage (stage 4) cancer is metastases or secondary tumours which are caused by tumour cells spreading to different locations in the body. Metastases are particularly associated with breast cancer, which is the most common cancer in females and the leading cause of cancer deaths in this group. Figures vary but some studies put a figure of about 50-60 % of patients will have bone metastases in late stage cancer. The tumours weaken the bone and lead to a variety of problems for the patients at a time when quality of life is a paramount consideration, especially as the prognosis is usually terminal. Significant issues include severe pain and spinal fracture which made lead to spinal cord injury. These complications often require major surgery which encroaches, significantly, on the patients' quality of life, when life expectancy is a matter of months and may, in certain cases, provide a mechanism of further spread of the cancer. Currently, there are no implants for supporting the bones before fracture as we cannot identify which vertebrae are likely to fail. OncoEng will deliver a paradigm shift in the current treatment technologies and stratification of care based on the application of core enabling engineering technologies. A more patient-friendly approach is realised in OncoEng in which we predict which vertebrae with tumours are likely to fail in the future enabling informed decision on care. Advanced computational modelling and imaging will be used to look at the growth of the tumour so that predictions of the strength of the vertebrae can be calculated a different points in time. These strengths can then be compared to spinal loads and an assessment of fracture risk undertaken. Those vertebrae at his risk would then receive special implant to support the weakened bone and prevent fracture. This implant would only require key-hole surgery and would not impinge on the patient's quality of life through a lengthy recuperation period or additional pain. The research proposed responds to the Cancer Strategy in the NHS Long Term Plan and the EU's Beating Cancer Plan.Three Universities in the UK, University of Leeds, Imperial College and University College London, have come together to deliver this research so as to make a big change in the way these patients are treated. In addition we have formed an international network of academic, industrial and clinical collaborators from Europe, USA and Australia (OncoEng+ Network) with a focus on novel modelling, imaging, advanced materials and innovative medical devices to overcome the challenges of predicting fracture and producing a new implant. Impacts from the research include (1) new diagnostic tools for predicting bone failure using imaging and advanced computational modelling, which can be used in this and other disease such as osteoporosis, (2) a new patient-specific implant that can be inserted using minimally invasive surgery reducing the trauma to the patient and having a shorter recovery period (days rather than weeks or months); the implant would be inserted before the vertebrae is susceptible to fracture, (3) new manufacturing techniques for the delivery of the minimally invasive implant, which have wide ranging applications outside medicine including the aerospace and automotive sector, and (4) new test methodologies for spinal implants to ensure that these devices are tested under a range of activities including adverse conditions such as high patient loading. Importantly, the programme grant will train and up-skill a new generation engineers and scientists in a novel area of application-based research, that of devices for skeletal cancers and software for fracture prediction, and aims to bring together activities in the UK and internationally to form a holistic integrated activity.

在英国，大约有200万人患有癌症，这一数字将在未来十年中大幅增长到320万。晚期（第4阶段）癌症的显着并发症是转移或继发性肿瘤，这些肿瘤是由肿瘤细胞扩散到体内不同位置的。转移量特别与乳腺癌有关，乳腺癌是女性最常见的癌症，也是该组癌症死亡的主要原因。数字有所不同，但一些研究使约50-60％的患者的数字在晚期癌症中会有骨转移。在生活质量是至关重要的时候，肿瘤会削弱骨骼，并导致患者的各种问题，尤其是因为预后通常是终极的。重大问题包括严重的疼痛和脊柱骨折，导致脊髓损伤。这些并发症通常需要进行重大手术，这些手术显着侵犯了患者的生活质量，而预期寿命为几个月的问题，并且在某些情况下可能会提供进一步传播癌症的机制。当前，没有植入物在骨折之前支撑骨骼，因为我们无法确定哪些椎骨可能会失败。 Oncoeng将根据核心启用工程技术的应用，对当前治疗技术进行范式转变和护理分层。在Oncoeng中实现了一种更适合患者的方法，在该方法中，我们预测哪些椎骨在将来可能会失败，从而实现明智的护理决定。先进的计算建模和成像将用于研究肿瘤的生长，以便可以计算出不同时间点的椎骨强度的预测。然后可以将这些优势与脊柱负荷和对骨折风险的评估进行比较。然后，那些处于他风险的椎骨会收到特殊植入物，以支撑弱的骨骼并防止骨折。该植入物只需要钥匙孔手术，并且不会在长时间的恢复期或额外的疼痛中造成患者的生活质量。这项研究提出了对NHS长期计划和欧盟殴打癌症计划中的癌症战略的回应。英国的三所大学，利兹大学，帝国学院和伦敦大学伦敦大学，共同提供了这项研究，以对这些患者的治疗方式进行重大变化。此外，我们还建立了来自欧洲，美国和澳大利亚（Oncoeng+网络）的学术，工业和临床合作者的国际网络，重点是新型建模，成像，高级材料和创新的医疗设备，以克服预测断裂和生产新植入物的挑战。该研究的影响包括（1）使用成像和先进的计算建模预测骨骼破坏的新诊断工具，可用于这种和其他疾病，例如骨质疏松症，（2）一种新的特异性植入物，可以使用微小入侵性手​​术插入，以减少患者的创伤，并减少患者的创伤，并在恢复期或几个月（而不是几个月）中，而不是几个月（而不是几个月）；植入物将在椎骨易于裂缝之前插入，（3）用于提供微型侵入性植入物的新制造技术，这些技术在医学外具有广泛的应用，包括航空航天和自动动力部门，以及（4）脊柱植入物的新测试方法，以确保这些设备在这些设备中进行了较高的范围。重要的是，该计划赠款将在基于应用程序的研究，骨骼癌的设备以及用于裂缝预测的软件的新型研究中进行培训和提高新一代工程师和科学家，并旨在在英国和国际上汇集活动，以组成一项整体综合活动。