Nutritional Support and Prevention of Complications in Treatment Contribute to Improved Prognosis in Pediatric Diffuse Intrinsic Pontine Glioma Patients

Abstract

Background Diffuse intrinsic pontine glioma (DIPG), a malignant brain tumor in children, lacks effective treatment options, often presents with multiple complications during treatment, and has a poor prognosis. Objective To define the correlation between nutritional status, complications, and prognosis in pediatric patients with DIPG. Methods Clinical data were retrieved from the hospital database and follow-up, and the following clinical data of patients were organized and analyzed: age, gender, Karnofsky performance status (KPS) score at admission, treatment received, occurrence of pneumonia, onset of bed rest, overall survival (OS), 12-month survival rate, time to progression, occurrence of venous thrombosis, and prognostic nutritional index (PNI) at three stages after onset, within one week after radiotherapy, and in the last follow-up. Results A total of 34 patients met the inclusion criteria from January 2017 to June 2022. The average age was 9.0 years, and 47.1% were female. The median KPS score was 70 at admission. 29.4% of the patients were definitively diagnosed with pneumonia during the treatment of the disease, 32.4% had upper extremity venous thrombosis, and 29.4% had lower extremity venous thrombosis. The median OS of the patients was 9.2 months, and the median progression time was 4.7 months. The PNI was correlated at three stages, and it was the highest after radiotherapy (43.6 ± 8.2). Through COX survival analysis, we found that the occurrence of venous thrombosis was a disadvantageous factor for patient prognosis. The prolongation of the median progression time and the increase of the PNI at the three stages were positively correlated with the good prognosis of the patients. Conclusion High PNI sore and prevention of complications exert positive role in the prognosis of DIPG patients.