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KMID : 1035520190070020074
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Brain Tumor Research and Treatment : BTRT
2019 Volume.7 No. 2 p.74 ~ p.84
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The Korean Society for Neuro-Oncology (KSNO) Guideline for WHO Grade II Cerebral Gliomas in Adults: Version 2019.01
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Kim Young-Zoon
Kim Chae-Yong
Wee Chan-Woo
Roh Tae-Hoon
Hong Je-Beom
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
Park Jae-Sung
Park Hyun-Jin
Song Sang-Woo
Sung Kyoung-Su
Yang Seung-Ho
Yoon Wan-Soo
Yoon Hong-In
Lee Ji-Hae
Lee Soon-Tae
Lee Sea-Won
Lee Youn-Soo
Lim Jae-Joon
Chang Jong-Hee
Jung Tae-Young
Jung Hye-Lim
Cho Jae-Ho
Choi Seung-Hong
Choi Hyoung-Soo
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 for many years. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has developed the guideline for glioblastoma. Subsequently, the KSNO guideline for World Health Organization (WHO) grade II cerebral glioma in adults is established.
Methods: The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified by searching PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL databases using specific and sensitive keywords as well as combinations of keywords regarding diffuse astrocytoma and oligodendroglioma of brain in adults.
Results: Whenever radiological feature suggests lower grade glioma, the maximal safe resection if feasible is recommended globally. After molecular and histological examinations, patients with diffuse astrocytoma, isocitrate dehydrogenase (IDH)-wildtype without molecular feature of glioblastoma should be primarily treated by standard brain radiotherapy and adjuvant temozolomide chemotherapy (Level III) while those with molecular feature of glioblastoma should be treated following the protocol for glioblastomas. In terms of patients with diffuse astrocytoma, IDH-mutant and oligodendroglioma (IDH-mutant and 1p19q codeletion), standard brain radiotherapy and adjuvant PCV (procarbazine+lomustine+vincristine) combination chemotherapy should be considered primarily for the high-risk group while observation with regular follow up should be considered for the low-risk group.
Conclusion: The KSNO's guideline recommends that WHO grade II gliomas should be treated by maximal safe resection, if feasible, followed by radiotherapy and/or chemotherapy according to molecular and histological features of tumors and clinical characteristics of patients.
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KEYWORD
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Korean Society for Neuro-Oncology, Guideline, Grade II Gliomas, Practice
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