Multi-institutional study of treatment patterns in Korean patients with WHO grade II gliomas: KNOG 15-02 and KROG 16-04 intergroup study

• DOI: 10.1007/s11060-018-2839-z
• Publication Date: 2018-03-23T11:34:12Z
• Authors: Taeryool Koo; Do Hoon Lim; Ho Jun Seol; Chul-Kee Park; Il Han Kim; Jong Hee Chang; Jeongshim Lee; Shin Jung; Ho-Shin Gwak; Kwan Ho Cho; Chang-Ki Hong; Ik Jae Lee; El Kim; Jin Hee Kim; Yong-Kil Hong; Hong Seok Jang; Chae-Yong Kim; In Ah Kim; Sung Hwan Kim; Young Il Kim; Eun-Young Kim; Woo Chul Kim; Semie Hong
• Keywords: Adult; Male; Low-grade glioma; Patterns of care; 610; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Republic of Korea; Temozolomide; Humans; Practice Patterns, Physicians'; Aged; Retrospective Studies; Cerebral Cortex; Radiotherapy; Brain Neoplasms; Glioma; Middle Aged; Survival Analysis; 3. Good health; Treatment Outcome; Female; Neoplasm Grading; PCV

We performed this study to identify the treatment patterns of patients with low-grade gliomas (LGG) in Korea.A total of 555 patients diagnosed as WHO grade II gliomas between 2000 and 2010 at 14 Korean institutions were included. The patients were divided into four adjuvant treatment groups: adjuvant fractionated radiotherapy (RT, N = 204), adjuvant chemotherapy (N = 20), adjuvant fractionated RT and chemotherapy (N = 65), and non-adjuvant treatment (N = 266) groups. We examined differences among the groups and validated patient/tumor characteristics associated with the adjuvant treatments.Astrocytoma was diagnosed in 210 patients (38%), oligoastrocytoma in 85 patients (15%), and oligodendroglioma in 260 patients (47%). Gross total resection was performed in 200 patients (36%), subtotal resection in 153 (28%), partial resection in 71 patients (13%), and biopsy in 131 patients (24%). RT was most commonly applied as an adjuvant treatment. The use of chemotherapy with or without RT decreased after 2008 (from 38 to 4%). The major chemotherapeutic regimen was procarbazine, lomustine, and vincristine (PCV); however, the proportion of temozolomide increased since 2005 (up to 69%). Patient/tumor characteristics related with RT were male gender, non-seizure, multiple lobes involvement, and non-gross total resection. Chemotherapy was associated with non-gross total resection and non-astrocytoma.A preference for RT and increased use of temozolomide was evident in the treatment pattern of LGG. The extent of resection was associated with a decision to perform RT and chemotherapy. To establish a robust guideline for LGG, further studies including molecular information are needed.