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.
Introduction: Optimum nutrition is the cornerstone of child growth and development. Childhood is a period of rapid growth and development. Children of preschool age have higher nutritional needs and are often at risk of nutrient deficiencies.
Objective: The present study was designed to evaluate the effect of an oral nutritional supplement (ONS) on growth parameters in a representative population.
Methods: We used the systems-biology-based mathematical model for child growth to analyze the effect of ONS on growth in a representative in silico population of preschool children. The analysis included changes in average growth velocities of weight, height, muscle mass, fat mass, fat-free mass, and bone mass. We used meta-data analysis for evaluating the absorption of micronutrients present in the ONS that affects growth in preschool children.
Results: The results of the analysis showed one serving of ONS in milk/day improved the weight gain velocity by 1.7 times in preschool children. The linear growth was 1.04 times higher than the control. The absorption of micronutrients such as iron, vitamin K, calcium, and magnesium was higher in the ONS group.
Conclusions: This study indicates that the ONS containing macro and micronutrients, docosahexaenoic acid (DHA), and prebiotics can potentiate growth and development in preschool children. It provides micronutrients that can be readily absorbed which are essential for other vital functions in the body.
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