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KMID : 1035520230110020123
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Brain Tumor Research and Treatment
2023 Volume.11 No. 2 p.123 ~ p.132
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The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Recommendation Using the Delphi Method (Version 2023.1)
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Kim Min-Sung
Kim Dae-Joon
Wee Chan-Woo
Lee Min-Ho
Kang Seok-Gu
Go Kyeong-O
Kwon Sae-Min
Kim Woo-Hyun
Dho Yun-Sik
Nodirbek Yuldashev Sodirzhon-Ugli
Seo Young-Beom
Song Sang-Woo
Kim Min-Chul
Oh Hyuk-Jin
Cho Yong-Soo
Lee Sea-Won
Lee Joo-Ho
Cho Kyung-Rae
Choi Jung-Won
Hong Je-Beom
Hwang Ki-Hwan
Park Chul-Kee
Lim Do-Hoon
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Abstract
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Background : During the coronavirus disease 2019 (COVID-19) pandemic, the need for appropriate treatment guidelines for patients with brain tumors was indispensable due to the lack and limitations of medical resources. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has undertaken efforts to develop a guideline that is tailored to the domestic situation and that can be used in similar crisis situations in the future.
Methods : The KSNO Guideline Working Group was composed of 22 multidisciplinary experts on neuro-oncology in Korea. In order to reach consensus among the experts, the Delphi method was used to build up the final recommendations.
Results : All participating experts completed the series of surveys, and the results of final survey were used to draft the current consensus recommendations. Priority levels of surgery and radiotherapy during crises were proposed using appropriate time window-based criteria for management outcome. The highest priority for surgery is assigned to patients who are life-threatening or have a risk of significant impact on a patient’s prognosis unless immediate intervention is given within 24?48 hours. As for the radiotherapy, patients who are at risk of compromising their overall survival or neurological status within 4?6 weeks are assigned to the highest priority. Curative-intent chemotherapy has the highest priority, followed by neoadjuvant/adjuvant and palliative chemotherapy during a crisis period. Telemedicine should be actively considered as a management tool for brain tumor patients during the mass infection crises such as the COVID-19 pandemic.
Conclusion : It is crucial that adequate medical care for patients with brain tumors is maintained and provided, even during times of crisis. This guideline will serve as a valuable resource, assisting in the delivery of treatment to brain tumor patients in the event of any future crisis.
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KEYWORD
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Korean Society for Neuro-Oncology, Guideline, Brain tumors, Crisis, Delphi
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