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KMID : 1035520200080010020
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Brain Tumor Research and Treatment : BTRT
2020 Volume.8 No. 1 p.20 ~ p.28
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A National Consensus Survey for Current Practice in Brain Tumor Management III: Brain Metastasis and Primary Central Nervous System Lymphoma
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Kim Sung-Kwon
Park Ji-Eun
Kim Kyung-Hwan
Cho Jin-Mo
Moon Jang-Sup
Yoon Wan-Soo
Kim Se-Hoon
Kim Young-Il
Kim Young-Zoon
Kim Ho-Sung
Dho Yun-Sik
Park Jae-Sung
Yoon Hong-In
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 the nationwide questionnaire survey for diverse queries facing to treat patients with brain tumor. As part III of the survey, the aim of this study is to evaluate the national patterns of clinical practice for patients with brain metastasis and primary central nervous system lymphoma (PCNSL).
Methods: A web-based survey was sent to all members of the KSNO by email. The survey included 7 questions of brain metastasis and 5 questions of PCNSL, focused on the management strategies in specific situations. All questions were developed by consensus of the Guideline Working Group.
Results: In the survey about brain metastasis, respondents preferred surgical resection with adjuvant treatment for patients with a surgically accessible single brain metastatic lesion less than 3 cm in size without extracranial systemic lesions. However, most respondents considered radiosurgery for surgically inaccessible lesions. As the preferred treatment of multiple brain metastases according to the number of brain lesions, respondents tended to choose radiotherapy with increasing number of lesions. Radiosurgery was mostly chosen for the brain metastases of less than or equal to 4. In the survey about PCNSL, a half of respondents choose high-dose methotrexate-based polychemotherapy as the first-line induction therapy for PCNSL. The consolidation and salvage therapy showed a little variation among respondents. For PCNSL patients with cerebrospinal fluid dissemination, intrathecal chemotherapy was most preferred.
Conclusion: The survey demonstrates the prevailing clinical practice patterns for patients with brain metastasis and PCNSL among members of the KSNO. This information provides a point of reference for establishing a practical guideline in the management of brain metastasis and PCNSL.
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KEYWORD
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Korean Society for Neuro-Oncology, Practice patterns, Brain tumors, Metastasis, Lymphoma, Guideline Working Group
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