Brain Tumor Res Treat.  2023 Apr;11(2):123-132. 10.14791/btrt.2023.0009.

The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Recommendation Using the Delphi Method (Version 2023.1)

• Kim MS
• Go SI
• Wee CW
• Lee MH
• Kang SG
• Go KO
• Kwon SM
• Kim W
• Dho YS
• Park SH
• Seo Y
• Song SW
• Ahn S
• Oh HJ
• Yoon HI
• Lee SW
• Lee JH
• Cho KR
• Choi JW
• Hong JB
• Hwang K
• Park CK
• Lim DH
• KSNO Guideline Working Group

• KMID: 2542084
• DOI: http://doi.org/10.14791/btrt.2023.0009

Abstract

Background
During the coronavirus disease 2019 (COVID-19) pandemic, the need for appropriate treatment guidelines for patients with brain tumors was indispensable due to the lack and limitations of medical resources. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has undertaken efforts to develop a guideline that is tailored to the domestic situation and that can be used in similar crisis situations in the future.
Methods
The KSNO Guideline Working Group was composed of 22 multidisciplinary experts on neuro-oncology in Korea. In order to reach consensus among the experts, the Delphi method was used to build up the final recommendations.
Results
All participating experts completed the series of surveys, and the results of final survey were used to draft the current consensus recommendations. Priority levels of surgery and radiotherapy during crises were proposed using appropriate time window-based criteria for management outcome. The highest priority for surgery is assigned to patients who are life-threatening or have a risk of significant impact on a patient’s prognosis unless immediate intervention is given within 24–48 hours. As for the radiotherapy, patients who are at risk of compromising their overall survival or neurological status within 4–6 weeks are assigned to the highest priority. Curative-intent chemotherapy has the highest priority, followed by neoadjuvant/adjuvant and palliative chemotherapy during a crisis period. Telemedicine should be actively considered as a management tool for brain tumor patients during the mass infection crises such as the COVID-19 pandemic.
Conclusion
It is crucial that adequate medical care for patients with brain tumors is maintained and provided, even during times of crisis. This guideline will serve as a valuable resource, assisting in the delivery of treatment to brain tumor patients in the event of any future crisis.

Keyword

Korean Society for Neuro-Oncology; Guideline; Brain tumors; Crisis; Delphi

Figure

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  Fig. 1 Flow chart of the Delphi process employed in the guideline.

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