J Korean Neurosurg Soc.  2023 May;66(3):308-315. 10.3340/jkns.2023.0046.

Korean Brain Tumor Society Consensus Review for the Practical Recommendations on Glioma Management in Korea

Affiliations
  • 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 2Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Abstract

Recent updates in genomic-integrated glioma classification have caused confusion in current clinical practice, as management protocols and health insurance systems are based on evidence from previous diagnostic classifications. The Korean Brain Tumor Society conducted an electronic questionnaire for society members, asking for their ideas on risk group categorization and preferred treatment for each individual diagnosis listed in the new World Health Organization (WHO) classification of gliomas. Additionally, the current off-label drug use (OLDU) protocols for glioma management approved by the Health Insurance Review and Assessment Service (HIRA) in Korea were investigated. A total of 24 responses were collected from 20 major institutes in Korea. A consensus was reached on the dichotomic definition of risk groups for glioma prognosis, using age, performance status, and extent of resection. In selecting management protocols, there was general consistency in decisions according to the WHO grade and the risk group, regardless of the individual diagnosis. As of December 2022, there were 22 OLDU protocols available for the management of gliomas in Korea. The consensus and available options described in this report will be temporarily helpful until there is an accumulation of evidence for effective management under the new classification system for gliomas.

Keyword

Glioma; Korean Brain Tumor Society; Off-label drug use; Consensus

Figure

  • Fig. 1. Summary of the responses from an online survey on the preferred management plan for newly diagnosed gliomas according to the new World Health Organization (WHO) classification (numbers are shown in the color bar indicating the number of respondents). RT : radiotherapy, CT : chemotherapy, CCRT : concomitant chemoradiotherapy, IDH : isocitrate dehydrogenase.


Reference

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