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KMID : 1035520200080010011
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Brain Tumor Research and Treatment : BTRT
2020 Volume.8 No. 1 p.11 ~ p.19
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A National Consensus Survey for Current Practice in Brain Tumor Management II: Diffuse Midline Glioma and Meningioma
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Kim Sung-Kwon
Yoon Hong-In
Yoon Wan-Soo
Cho Jin-Mo
Moon Jang-Sup
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
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 II of the survey, the aim of this study is to evaluate the national patterns of clinical practice for patients with diffuse midline glioma and meningioma.
Methods: A web-based survey was sent to all members of the KSNO by email. The survey included 4 questions of diffuse midline glioma and 6 questions of meningioma (including 2 case scenarios). All questions were developed by consensus of the Guideline Working Group.
Results: In the survey about diffuse midline glioma, 76% respondents performed histologic confirmation to identify H3K27M mutation on immunohistochemical staining or sequencing methods. For treatment of diffuse midline glioma, respondents preferred concurrent chemoradiotherapy with temozolomide (TMZ) and adjuvant TMZ (63.8%) than radiotherapy alone (34.0%). In the survey about meningioma, respondents prefer wait-and-see policy for the asymptomatic small meningioma without peritumoral edema. However, a greater number of respondents had chosen surgical resection as the first choice for all large size meningiomas without exception, and small size meningiomas with either peritumoral edema or eloquent location. There was no single opinion with major consensus on long-term follow-up plans for asymptomatic meningioma with observation policy. As many as 68.1% of respondents answered that they would not add any adjuvant therapies for World Health Organization grade II meningiomas if the tumor was totally resected including dura.
Conclusion: The survey demonstrates the prevailing clinical practice patterns for patients with diffuse midline glioma and meningioma among members of the KSNO. This information provides a point of reference for establishing a practical guideline in the management of diffuse midline glioma and meningioma.
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KEYWORD
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Korean Society for Neuro-Oncology, Practice patterns, Brain tumors, Diffuse midline glioma, Meningioma, Guideline Working Group
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