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KMID : 1035520190070020063
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Brain Tumor Research and Treatment : BTRT
2019 Volume.7 No. 2 p.63 ~ p.73
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The Korean Society for Neuro-Oncology (KSNO) Guideline for WHO Grade III Cerebral Gliomas in Adults: Version 2019.01
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Kim Young-Zoon
Kim Chae-Yong
Lim Jae-Joon
Sung Kyoung-Su
Lee Ji-Hae
Oh Hyuk-Jin
Kang Seok-Gu
Kang Shin-Hyuk
Kong Doo-Sik
Kim Sung-Hwan
Kim Se-Hyuk
Kim Se-Hoon
Kim Yu-Jung
Kim Eui-Hyun
Kim In-Ah
Kim Ho-Sung
Roh Tae-Hoon
Park Jae-Sung
Park Hyun-Jin
Song Sang-Woo
Yang Seung-Ho
Yoon Wan-Soo
Yoon Hong-In
Lee Soon-Tae
Lee Sea-Won
Lee Youn-Soo
Wee Chan-Woo
Chang Jong-Hee
Jung Tae-Young
Jung Hye-Lim
Cho Jae-Ho
Choi Seung-Hong
Choi Hyoung-Soo
Hong Je-Beom
Lim Do-Hoon
Chung Dong-Sup
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Abstract
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Background: There was no practical guideline for the management of patients with central nervous system tumor in Korea in the past. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, developed the guideline for glioblastoma successfully and published it in Brain Tumor Research and Treatment, the official journal of KSNO, in April 2019. Recently, the KSNO guideline for World Health Organization (WHO) grade III cerebral glioma in adults has been established.
Methods: The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified by searches in PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL databases using specific and sensitive keywords as well as combinations of keywords. Scope of the disease was confined to cerebral anaplastic astrocytoma and oligodendroglioma in adults.
Results: Whenever radiological feature suggests high grade glioma, maximal safe resection if feasible is globally recommended. After molecular and histological examinations, patients with anaplastic astrocytoma, isocitrate dehydrogenase (IDH)-mutant should be primary treated by standard brain radiotherapy and adjuvant temozolomide chemotherapy whereas those with anaplastic astrocytoma, NOS, and anaplastic astrocytoma, IDH-wildtype should be treated following the protocol for glioblastomas. In terms of anaplastic oligodendroglioma, IDH-mutant and 1p19q-codeletion, and anaplastic oligodendroglioma, NOS should be primary treated by standard brain radiotherapy and neoadjuvant or adjuvant PCV (procarbazine, lomustine, and vincristine) combination chemotherapy.
Conclusion: The KSNO's guideline recommends that WHO grade III cerebral glioma of adults should be treated by maximal safe resection if feasible, followed by radiotherapy and/or chemotherapy according to molecular and histological features of tumors.
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KEYWORD
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Korean Society for Neuro Oncology, Guideline, Grade III Gliomas, Practice
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