Peer-reviewed article
LINC-08. INCREASED TREATMENT TOXICITIES AND INFERIOR OUTCOMES IN UNDERNOURISHED CHILDREN WITH BRAIN TUMOURS
Prasad M, Chheda E, Chinnaswamy G, Gupta T, Krishnatry R et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how nutritional status affects children undergoing treatment for brain tumours. Children who were undernourished at diagnosis had worse survival outcomes and experienced more treatment-related toxicities, including all three treatment deaths. Weight loss during treatment was associated with higher rates of toxicity. The findings suggest that better nutritional monitoring and intervention are needed for children receiving cancer treatment.
Key points
- 70% of undernourished children were alive in remission compared to 88% of well-nourished children at follow-up
- Toxicity occurred in 50% of undernourished children versus 24% of well-nourished children
- All three toxic deaths occurred in the undernourished group
- Weight loss during treatment was associated with 70% toxicity rate, compared to 30% with stable weight and 20% with weight gain
- Despite nutritional intervention, 19% of children lost weight during treatment
Limitations
This is a retrospective audit with nutritional status data available for only 59% of patients at diagnosis and 47% at follow-up, which may introduce selection bias. The small sample size and single-centre design limit generalisability of the findings.
Abstract
Abstract BACKGROUND Children on treatment for brain tumours are known to be at high risk of undernutrition, the impact on outcome and toxicity is not well understood. METHODS Retrospective audit of children(<18 years)diagnosed January 2017-December 2018 with embryonal brain tumours (medulloblastoma, primitive neuro-ectodermal tumors, pinealoblastoma, atypical teratoid/rhabdoid tumour) and treated at our centre. Data was retrieved from case records and electronic medical records. Nutritional status(NS) was defined as per World Health Organization (WHO) into severe malnutrition (SAM),moderate malnutrition (MAM),well nourished (WN) and overweight. Undernutrition(UN) was defined as SAM/MAM.Toxicity was documented till end of treatment,defined as treatment delay>1week,significant infection or toxic death. RESULTS Of 124 eligible patients who received entire chemotherapy at our centre, NS data was available in 73 at diagnosis and 58 at follow-up. At diagnosis-29,16,26 and 2 and at follow-up-20,16,22 and 0 were SAM,MAM,WN and overweight. During treatment, weight gain was documented in 26%, stable weight in 55% and weight loss in 19%. Those UN at diagnosis had worse outcomes at follow-up with 70% alive in remission compared to 88% of WN(p-0.14). There was increased toxicity in UN group(50%) compared to WN(24%),p-0.04.All 3 toxic deaths were in UN. Those who lost weight during treatment had higher toxicities(70%) compared to those with stable weight (30%)or weight gain(20%),p-0.02. CONCLUSIONS In spite of nutritional intervention, children on treatment for brain tumours tend to lose weight. Increased treatment toxicities and inferior outcomes in undernourished children with brain tumours necessitates proactive and aggressive nutritional monitoring and intervention.