Endocrine Abstracts

JOINT3935

Introduction: Brain tumors are the most common solid tumor in children. These patients may have an increased risk of obesity due to the location of the tumor (hypothalamus) or by the oncological therapies.

Objectives: To characterize a population of brain tumor survivors in pediatric age using body mass index to assess risk factors of overweight/obesity.

Methods: Retrospective analysis of the medical records of patients diagnosed with a brain tumor in pediatric age, followed up in the Endocrinology Late-effects clinics of our center. The statistical analysis was performed using SPSS software.

Results: We obtained a sample of 181 patients, 103 (57%) of whom were male. The median age at the diagnosis of brain tumor was 5. 7 (0-17. 8) years. The most prevalent tumor types were astrocytomas (38. 7%) and medulloblastomas (24. 3%). The most common locations were the diencephalic sellar/suprasellar region (38. 9%) and the posterior fossa (36. 7%). Of the 181 patients, 74. 6% underwent surgery, 74% received chemotherapy and 53% received central nervous system radiation, with a median dose of 54Gy (17. 2-60). At least one endocrinopathy was present in 64. 6% of patients, with the most prevalent being GH deficiency (45. 3%), hypothyroidism (37%), and pubertal alterations (28. 2%). At the start of follow-up, 62. 9% of the patients were of normal weight/underweight, 13. 3% were overweight, and 23. 8% were obese. At last follow-up, 50. 2% were of normal weight/underweight, 27. 1% were overweight, and 22. 7% were obese. Regarding the patients who had already reached the adulthood in the last follow-up (n = 101), 19 (18. 81%) were obese – 14 (13. 86%) had class I obesity, 3 (2. 97%) had class II obesity, and 2 (1. 98%) had class III obesity. The median follow-up was 9 (0-29) years. The patients were divided into two groups (according to status in the last appointment): group A, with overweight/obesity, and group B, with normal weight/underweight. No statistically significant differences were identified between the groups regarding sex, age at diagnosis, and tumor location. Group A included significantly more patients who had undergone brain radiation (P < 0. 001). This group also had a significantly higher number of patients with endocrinopathies (P = 0. 006), with a notably greater number of patients having pubertal changes and hypothyroidism.

Conclusions: At the end of follow-up, 49. 8% of the patients had overweight or obesity. With this work we highlighted risk factors for weight gain in these patients. It’s important to identify those at higher risk in order to adopt strategies of weight control in these patients.