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KMID : 1035520200080010001
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Brain Tumor Research and Treatment : BTRT
2020 Volume.8 No. 1 p.1 ~ p.10
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A National Consensus Survey for Current Practice in Brain Tumor Management I: Antiepileptic Drug and Steroid Usage
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Kim Sung-Kwon
Moon Jang-Sup
Cho Jin-Mo
Kim Kyung-Hwan
Kim Se-Hoon
Kim Young-Il
Kim Young-Zoon
Kim Ho-Sung
Dho Yun-Sik
Park Jae-Sung
Park Ji-Eun
Seo Young-Beom
Sung Kyoung-Su
Song Jin-Ho
Wee Chan-Woo
Yoon Wan-Soo
Yoon Hong-In
Lee Se-Hoon
Lim Do-Hoon
Im Jung-Ho
Chang Jong-Hee
Han Myung-Hoon
Hong Je-Beom
Hwang Ki-Hwan
Park Chul-Kee
Lee Youn-Soo
Gwak Ho-Shin
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Abstract
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Background: The Guideline Working Group of the Korean Society for Neuro-Oncology (KSNO) conducted a nationwide questionnaire survey for diverse queries faced in the treatment of brain tumors. As part I of the survey, the aim of this study is to evaluate national patterns of clinical practice about antiepileptic drug (AED) and steroid usage for management of brain tumors.
Methods: A web-based survey was sent to all members of the KSNO by email. The survey included 9 questions of AED usage and 5 questions of steroid usage for brain tumor patients. All questions were developed by consensus of the Guideline Working Group.
Results: The overall response rate was 12.8% (54/423). Regarding AED usage, the majority of respondents (95.2%) routinely prescribed prophylactic AEDs for patients with seizure at the peri/postoperative period. However, as many as 72.8% of respondents prescribed AED routinely for seizure-naive patients, and others prescribed AED as the case may be. The duration of AED prophylaxis showed wide variance according to the epilepsy status and the location of tumor. Levetiracetam (82.9%) was the most preferred AED for epilepsy prophylaxis. Regarding steroid usage, 90.5% of respondents use steroids in perioperative period, including 34.2% of them as a routine manner. Presence of peritumoral edema (90.9%) was considered as the most important factor determining steroid usage followed by degree of clinical symptoms (60.6%). More than half of respondents (51.2%) replied to discontinue the steroids within a week after surgery if there are no specific medical conditions, while 7.3% preferred slow tapering up to a month after surgery.
Conclusion: The survey demonstrated the prevailing practice patterns on AED and steroid usage in neuro-oncologic field among members of the KSNO. This information provides a point of reference for establishing a practical guideline in the management of brain tumor patients.
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KEYWORD
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Korean Society for Neuro-Oncology, Practice patterns, Brain tumors, Antiepileptic drugs, Steroids, Guideline Working Group
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