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

  • 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
Clinical Study

Abstract

Introduction

We performed this study to identify the treatment patterns of patients with low-grade gliomas (LGG) in Korea.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Patterns of care Low-grade glioma Radiotherapy PCV Temozolomide 

Supplementary material

11060_2018_2839_MOESM1_ESM.pptx (166 kb)
Supplementary material 1 (PPTX 165 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Taeryool Koo
    • 1
  • Do Hoon Lim
    • 2
  • Ho Jun Seol
    • 3
  • Chul-Kee Park
    • 4
  • Il Han Kim
    • 5
  • Jong Hee Chang
    • 6
  • Jeongshim Lee
    • 7
  • Shin Jung
    • 8
  • Ho-Shin Gwak
    • 9
  • Kwan Ho Cho
    • 10
  • Chang-Ki Hong
    • 11
  • Ik Jae Lee
    • 12
  • El Kim
    • 13
  • Jin Hee Kim
    • 14
  • Yong-Kil Hong
    • 15
  • Hong Seok Jang
    • 16
  • Chae-Yong Kim
    • 17
  • In Ah Kim
    • 18
  • Sung Hwan Kim
    • 19
  • Young Il Kim
    • 20
  • Eun-Young Kim
    • 21
  • Woo Chul Kim
    • 22
  • Semie Hong
    • 23
  1. 1.Department of Radiation OncologyHallym University Sacred Heart HospitalAnyangSouth Korea
  2. 2.Department of Radiation Oncology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Department of Neurosurgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  4. 4.Department of NeurosurgerySeoul National University College of MedicineSeoulSouth Korea
  5. 5.Department of Radiation OncologySeoul National University College of MedicineSeoulSouth Korea
  6. 6.Department of Neurosurgery, Yonsei Cancer CenterYonsei University College of MedicineSeoulSouth Korea
  7. 7.Department of Radiation Oncology, Yonsei Cancer CenterYonsei University College of MedicineSeoulSouth Korea
  8. 8.Department of Neurosurgery, Chonnam National University Medical SchoolChonnam National University Hwasun HospitalHwasunSouth Korea
  9. 9.Department of System Cancer Science, Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
  10. 10.Proton Therapy Center, Research Institute and HospitalNational Cancer CenterGoyangSouth Korea
  11. 11.Department of Neurosurgery, Brain Tumor Center, Gangnam Severance HospitalYonsei University College of MedicineSeoulSouth Korea
  12. 12.Department of Radiation Oncology, Gangnam Severance HospitalYonsei University College of MedicineSeoulSouth Korea
  13. 13.Department of Neurosurgery, Dongsan Medical CenterKeimyung University School of MedicineDaeguSouth Korea
  14. 14.Department of Radiation Oncology, Dongsan Medical CenterKeimyung University School of MedicineDaeguSouth Korea
  15. 15.Department of Neurosurgery, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  16. 16.Department of Radiation Oncology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  17. 17.Department of Neurosurgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
  18. 18.Department of Radiation Oncology, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
  19. 19.Department of Radiation Oncology, St. Vincent Hospital, College of MedicineThe Catholic University of KoreaSuwonSouth Korea
  20. 20.Department of Radiation OncologyChungnam National University School of MedicineDaejeonSouth Korea
  21. 21.Department of Neurosurgery, Inha University HospitalInha University of MedicineInchonSouth Korea
  22. 22.Department of Radiation Oncology, Inha University HospitalInha University of MedicineInchonSouth Korea
  23. 23.Department of Radiation Oncology, Konkuk University Medical Center, School of MedicineKonkuk UniversitySeoulSouth Korea

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