QOL-54. HEIGHT, WEIGHT AND CARDIOVASCULAR EFFECTS OF STIMULANTS ON CHILDREN WITH BRAIN TUMOR

Children with brain tumors may develop inattention, slow processing, and hypersomnia. Stimulant medications improve these problems but their effect on growth, heart rate, and blood pressure are inadequately explored. METHODS We retrospectively studied children with brain tumors treated at our institution that had data available for one-year pre and two year post stimulant treatment. Tumor location, gender, radiation treatment (RT), age at RT, drug type, and hormone therapy were variables of interest. RESULTS We identified 65 children (35 males) that fulfilled eligibility criteria. Focal RT was utilized in 58; 11 additionally received whole brain RT. Thirty were treated for hypersomnia and inattention, 8 for hypersomnia alone, and rest for inattention. Modafinil was the first drug in 18 (27.7%) and methylphenidate in the others. Forty-seven (72.3%), 40 (61.5%) and 49 (75.4%) were on thyroxine, cortisone and growth hormone respectively. There was no difference in pre and post stimulant BMI, heart rate, and blood pressure. There was also no difference between modafinil and methylphenidate groups. Rate of increase in height slowed on stimulants (p=0.0096). Thyroxine treatment correlated with increase in BMI after stimulants (p=0.0434). Younger age (p=0.0003) and higher BMI (p=0.0063) pre stimulants correlated with increased heart rate on stimulants, while higher age at RT (0.0159) correlated with elevated systolic BP on stimulants. No association of studied variables was found with height and diastolic BP. CONCLUSION Stimulants are well tolerated by children with brain tumors that are appropriately managed for endocrine deficiencies but may reduce the trajectory of height attainment.