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Evaluation of dietetic intervention in children with medulloblastoma or supratentorial primitive neuroectodermal tumors
Article first published online: 1 JUL 2003
Copyright © 2003 American Cancer Society
Volume 98, Issue 5, pages 1014–1020, 1 September 2003
How to Cite
Bakish, J., Hargrave, D., Tariq, N., Laperriere, N., Rutka, J. T. and Bouffet, E. (2003), Evaluation of dietetic intervention in children with medulloblastoma or supratentorial primitive neuroectodermal tumors. Cancer, 98: 1014–1020. doi: 10.1002/cncr.11598
- Issue published online: 20 AUG 2003
- Article first published online: 1 JUL 2003
- Manuscript Accepted: 23 MAY 2003
- Manuscript Revised: 5 MAY 2003
- Manuscript Received: 18 FEB 2003
- B. R. A. I. N. Child (Brain Tumour Assistance and Information Network)
- brain tumor;
- pediatric oncology;
- nutrition support;
- enteral nutrition;
- parenteral nutrition;
- gastrostomy tubes
Malnutrition is a common complication of cancer treatment; it can affect energy levels and, as a consequence, quality of life. The goal of the current study was to evaluate the effect of dietetic intervention in a cohort of children treated for medulloblastoma and supratentorial primitive neuroectodermal tumors (PNET) over a 10-year period.
A retrospective chart review (1992–2002) of newly diagnosed cases of medulloblastoma/supratentorial PNET was performed. Hospital records were reviewed for data, including demographic characteristics, patient heights and weights, and information on treatment modalities and the use of dietetic intervention. Percent changes in body weight were calculated at time points associated with particular stages of treatment or dietetic intervention.
One hundred three of 112 cases were evaluable. Treatment methods included surgery only (7.8%), surgery + radiotherapy (16.5%), surgery + chemotherapy (14.5%), and surgery + radiotherapy + chemotherapy (61.2%). There was no significant change in patient weight due to surgery (median change in body weight [MCBW], −0.35%) or radiotherapy (MCBW, −0.78%). In contrast, children experienced significant weight loss (MCBW, −4.35%; P < 0.0001) 3 months after starting chemotherapy. A dietician saw 53 of the 103 children in the study cohort. There were 84 dietetic interventions (oral, 36%; parenteral, 27%; enteral, 37%) among these 53 patients. Oral diets did not result in weight gain. Parenteral nutrition was associated with significant weight gain at 1 month (MCBW, +2.7%; P = 0.03), but not at 3 months. The use of enteral feeds resulted in significant weight gain at 1 month (MCBW, +4.8%; P = 0.006) and at 3 months (MCBW, +11.8%; P < 0.0001).
Current multimodality treatment of intracranial PNET results in significant nutritional morbidity, primarily due to the use of intensive chemotherapy regimens. Dietetic input for pediatric patients with medulloblastoma/PNET is essential, and the implementation of enteral feeding in these children can help to reverse their nutritional morbidity. Cancer 2003;98:1014–20. © 2003 American Cancer Society.