EVALUATION/TREATMENT OF TUMOR RELATED OBESITY IN PEDIATRIC BRAIN TUMOR PATIENTS

小儿脑肿瘤患者肿瘤相关肥胖的评估/治疗

• 批准号: 6116901
• 负责人: PATRICIA T MOLLOY
• 金额: $ 2.47万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-12-01 至 1999-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6116901
• 关键词: anxiety disorders; attention deficit disorder; behavior modification; behavioral /social science research tag; bioenergetics; body composition; child (0-11); clinical research; diagnosis quality /standard; echocardiography; fenfluramine; fluoxetine; glioma; human subject; human therapy evaluation; interview; major depression; medical complication; mental disorder diagnosis; metabolism disorder chemotherapy; mood disorders; obesity; outcomes research; pediatric neoplasm /cancer; posttraumatic stress disorder; radionuclide double label

Obesity and psychopathology are common in children with hypothalamic/chiasmatic gliomas (HCG) and craniopharyngiomas (CR). The aims of this study include: (1) To treat tumor-related obesity with combined pharmacologic therapy (phentermine with dl-fenfluramine or fluoxetine) and behavior modification; (2) To assess metabolism and body weight; and (3) To establish standard psychiatric diagnoses in this population. Methods used included: Anthroprometric assessment, bone density, body composition, resting and total energy expenditure with doubly labeled water and the diagnostic interview for children and adolescents (DICA), a structured psychiatric interview were completed. From March 1997 to September 1997, the medications used were dl- fenfluramine and phentermine. Five patients were enrolled and treated for greater than three months. All patients were between 165% to 243% of ideal body weight (IBW). Weight loss ranged from 2.9kg-13.2kg (mean = 7.5 kg). There was no significant toxicity and all echocardiograms were normal. All 5 patients fulfilled the criteria for both major depressive disorder or mood disorder, depressed type and post traumatic stress disorder. Four patients had secondary ADHD and 3 had generalized anxiety disorder. Only 1 patient had either pre-morbid obesity and pre-morbid psychiatric diagnosis. The FDA removed dl-fenfluramine from the market and this protocol was changed to the use of prozac and phentermine in November of 1997. Three new patients have been enrolled and treated for three months. These patients are between 160% and 255% of IBW. Thus far, weight loss has ranged from 4.1kg - 5.9kg (mean = 5kg). There has been no significant toxicity and all echocardiograms are normal. The study is expected to have 26 participants. Currently, active recruitment is underway. To date, conclusions include: (1) Weight loss is possible in children with morbid obesity due to hypothalamic/chiasmatic gliomas and craniopharyngiomas with combined pharmacologic and behavioral management. (2) The incidence of multiple psychiatric diagnoses is high and warrants further investigation and appropriate treatment strategies.

肥胖和心理病理学很常见 下丘脑/chiasmatic神经胶质瘤（HCG）和颅咽性咽喉瘤（CR）。 这 这项研究的目的包括：（1）用 联合药理疗法（苯丁胺与DL-芬氟胺或 氟西汀）和行为修改； （2）评估新陈代谢和身体 重量; （3）在此建立标准的精神病诊断 人口。 所使用的方法包括：人类测定，骨骼 密度，身体成分，休息和总能量消耗 双重标记的水和儿童的诊断访谈和 青少年（DICA）完成了结构化的精神病学访谈。 从1997年3月到1997年9月，所使用的药物是DL- 芬氟拉明和苯丁胺。 五名患者被招募并治疗 大于三个月。 所有患者均在165％至243％之间 理想的体重（IBW）。减肥范围为2.9kg-13.2kg（平均= 7.5 公斤）。没有明显的毒性，所有超声心动图均为 普通的。 所有5名患者都符合两个重大抑郁的标准 障碍或情绪障碍，类型抑郁和创伤后压力 紊乱。 四名患者患有多动症，3例患有普遍的焦虑 紊乱。 只有1名患者患有肥胖症前和疗程前患者 精神诊断。 FDA从市场中删除了DL-Fenfluramine，该协议是 1997年11月，变成了百忧解和芬特明的使用。 新患者已入学并治疗了三个月。 这些 患者在IBW的160％至255％之间。 到目前为止，减肥有 范围为4.1kg -5.9kg（平均= 5kg）。 没有意义 毒性和所有超声心动图均正常。 该研究预计将有26名参与者。 目前，活动 招募正在进行中。 迄今为止，结论包括：（1）减肥为 由于下丘脑/chiasmatic而导致病态肥胖儿童可能 具有药理学和行为的胶质瘤和颅脑瘤瘤 管理。 （2）多个精神病诊断的发生率很高 并保证进一步调查和适当的治疗策略。