ID #333 Striving for a healthy weight - A lifelong endeavor for children diagnosed with medulloblastoma
Ashley Meyer, Mary Schriewer, Michele McHugh, Ashley Lampe, Andrea Ogle, Mohamed Abdelbaki, Andrew ClusterAbstract
Background
Weight loss is one of the most common and challenging complications typically encountered during and after therapy for patients diagnosed with medulloblastoma. Nevertheless, its incidence and management strategies have been rarely reported.
Methods
A single institution retrospective analysis was conducted to characterize changes in weight and body mass index (BMI) before, during and after therapy in pediatric patients diagnosed with medulloblastoma. Secondary objectives included exploring the efficacy of weight management interventions and associated complications.
Results
A total of 35 patients were included. Age at diagnosis ranged from 4-20 years. Sixty percent received treatment per ACNS0331 and 40% per ACNS0332. All patients treated per ACNS0332 and 90.5% treated as per ACNS0331 experienced weight loss during therapy. At the end of treatment , only 57.1% of those treated per ACNS0331 and 42.9% of those treated per ACNS0332 had returned to their baseline weight. Most BMIs were categorized as underweight at baseline, throughout therapy, and until 1-year post-therapy. Within 5 years post completion of therapy, 56.5% of the patients had a healthy BMI. While 6–10-years after therapy 54.5% of patients were categorized as overweight or obese. A variety of weight management therapies were trialed. Megestrol outperformed all other interventions, followed by enteral feeding. Of those who received megestrol, 50% developed adrenal insufficiency while on megestrol and the remainder after discontinuing megestrol.
Conclusion
BMI and weight changes, whether gain or loss, should be carefully assessed and addressed before therapy begins and monitored across the lifespan to support the best possible outcomes for a healthy weight and lifestyle. Although megestrol was effective for weight gain, it should be used with caution in this population given the high incidence of adrenal insufficiency.