To describe weight gain and obesity-related complications amongst patients with glioblastoma.
A retrospective audit was conducted of patients with glioblastoma reviewed from 1/7/2015 – 1/7/2017 at Sir Charles Gairdner Hospital. Data was obtained from patient notes and electronic databases. Patient admissions were recorded. BMI was calculated at diagnosis and at last measurement before death. Dexamethasone exposure was quantified by recording dose at different time-points and calculating AUC using the trapezoidal method. Data analysis used SPSS v24. Univariate analyses using chi2 and independent T-Tests explored associations between dexamethasone exposure, obesity, weight gain, hospital admissions and place of death.
Data was collected from 100 patients. Of this cohort, 9 patients are still alive. 29 patients were referred to other centers, or did not receive chemotherapy. The median age of patients who received chemotherapy was 64 and the median overall survival was 12.2 months. At time of death, 24% were classed as overweight (BMI >25) and 30.6% were classified as obese (BMI >30). More than half (56.5%) demonstrated weight gain from time of diagnosis to death. Complications related to obesity and dexamethasone included hospital admissions for PE/DVT (8.1%, n=5) and sepsis (24.2%, n=15). In addition, cushingoid features (n=2), proximal myopathy (n=3), deranged BSLs requiring insulin (n=5) and psychosis/mania (n=2) were recorded in patient notes. On univariate analysis, patients with higher dexamethasone exposure were more likely to be admitted (p=0.021). There was a trend towards patients with higher dexamethasone exposure being more overweight at death (p=0.06). Being overweight at death may be associated with increased likelihood of dying in hospital/hospice rather than at home (p= 0.076).
Obesity is a significant issue for patients with glioblastoma. Attention should be paid to controlling weight gain and dexamethasone exposure in order to decrease the risk of steroid and obesity-related complications.