The Korean Society for Neuro-Oncology (KSNO) Guideline for WHO Grade III Cerebral Gliomas in Adults: Version 2019.01

Young Zoon Kim; Chae Yong Kim; Jaejoon Lim; Kyoung Su Sung; Jihae Lee; Hyuk Jin Oh; Seok Gu Kang; Shin Hyuk Kang; Doo Sik Kong; Sung Hwan Kim; Se Hyuk Kim; Se Hoon Kim; Yu Jung Kim; Eui Hyun Kim; In Ah Kim; Ho Sung Kim; Tae Hoon Roh; Jae Sung Park; Hyun Jin Park; Sang Woo Song; Seung Ho Yang; Wan Soo Yoon; Hong In Yoon; Soon Tae Lee; Sea Won Lee; Youn Soo Lee; Chan Woo Wee; Jong Hee Chang; Tae Young Jung; Hye Lim Jung; Jae Ho Cho; Seung Hong Choi; Hyoung Soo Choi; Je Beom Hong; Do Hoon Lim; Dong Sup Chung; KSNO Guideline Working Group

doi:10.14791/btrt.2019.7.e42

The Korean Society for Neuro-Oncology (KSNO) Guideline for WHO Grade III Cerebral Gliomas in Adults: Version 2019.01

Brain Tumor Res Treat. 2019 Oct;7(2):63-73. doi: 10.14791/btrt.2019.7.e42.

Authors

Young Zoon Kim¹, Chae Yong Kim², Jaejoon Lim³, Kyoung Su Sung⁴, Jihae Lee⁵, Hyuk Jin Oh⁶, Seok Gu Kang⁷, Shin Hyuk Kang⁸, Doo Sik Kong⁹, Sung Hwan Kim¹⁰, Se Hyuk Kim¹¹, Se Hoon Kim¹², Yu Jung Kim¹³, Eui Hyun Kim⁷, In Ah Kim¹⁴, Ho Sung Kim¹⁵, Tae Hoon Roh¹¹, Jae Sung Park¹⁶, Hyun Jin Park¹⁷, Sang Woo Song¹⁸, Seung Ho Yang¹⁹, Wan Soo Yoon²⁰, Hong In Yoon²¹, Soon Tae Lee²², Sea Won Lee²³, Youn Soo Lee²⁴, Chan Woo Wee¹⁴, Jong Hee Chang⁷, Tae Young Jung²⁵, Hye Lim Jung²⁶, Jae Ho Cho²¹, Seung Hong Choi²⁷, Hyoung Soo Choi²⁸, Je Beom Hong²⁹, Do Hoon Lim^#³⁰, Dong Sup Chung^#³¹; KSNO Guideline Working Group

Affiliations

¹ Division of Neurooncology and Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
² Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
³ Department of Neurosurgery, Bundang CHA Medical Center, CHA University, Seongnam, Korea.
⁴ Department of Neurosurgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
⁵ Department of Radiation Oncology, Ewha Women's University Mokdong Hospital, Ewha Women's University School of Medicine, Seoul, Korea.
⁶ Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
⁷ Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
⁸ Department of Neurosurgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
⁹ Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
¹⁰ Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
¹¹ Department of Neurosurgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
¹² Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
¹³ Division of Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
¹⁴ Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
¹⁵ Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
¹⁶ Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
¹⁷ Clinic of Pediatric Oncology, National Cancer Center, Goyang, Korea.
¹⁸ Department of Neurosurgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
¹⁹ Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
²⁰ Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
²¹ Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
²² Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
²³ Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
²⁴ Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
²⁵ Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea.
²⁶ Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
²⁷ Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
²⁸ Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
²⁹ Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
³⁰ Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. [email protected].
³¹ Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. [email protected].

^# Contributed equally.

Abstract

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.

Keywords: Grade III Gliomas; Guideline; Korean Society for Neuro Oncology; Practice.