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

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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.

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Authors and Affiliations

  1. Department of Radiation Oncology, Hallym University Sacred Heart Hospital, Anyang, South Korea

    Taeryool Koo

  2. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea

    Do Hoon Lim

  3. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Ho Jun Seol

  4. Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea

    Chul-Kee Park

  5. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea

    Il Han Kim

  6. Department of Neurosurgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea

    Jong Hee Chang

  7. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea

    Jeongshim Lee

  8. Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, South Korea

    Shin Jung

  9. Department of System Cancer Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea

    Ho-Shin Gwak

  10. Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, South Korea

    Kwan Ho Cho

  11. Department of Neurosurgery, Brain Tumor Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Chang-Ki Hong

  12. Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Ik Jae Lee

  13. Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea

    El Kim

  14. Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea

    Jin Hee Kim

  15. Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Yong-Kil Hong

  16. Department of Radiation Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Hong Seok Jang

  17. Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea

    Chae-Yong Kim

  18. Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea

    In Ah Kim

  19. Department of Radiation Oncology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea

    Sung Hwan Kim

  20. Department of Radiation Oncology, Chungnam National University School of Medicine, Daejeon, South Korea

    Young Il Kim

  21. Department of Neurosurgery, Inha University Hospital, Inha University of Medicine, Inchon, South Korea

    Eun-Young Kim

  22. Department of Radiation Oncology, Inha University Hospital, Inha University of Medicine, Inchon, South Korea

    Woo Chul Kim

  23. Department of Radiation Oncology, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, South Korea

    Semie Hong

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  1. Taeryool Koo
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  2. Do Hoon Lim
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  3. Ho Jun Seol
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  19. Sung Hwan Kim
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  20. Young Il Kim
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Correspondence to Do Hoon Lim.

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Koo, T., Lim, D.H., Seol, H.J. et al. Multi-institutional study of treatment patterns in Korean patients with WHO grade II gliomas: KNOG 15-02 and KROG 16-04 intergroup study. J Neurooncol 138, 667–677 (2018). https://doi.org/10.1007/s11060-018-2839-z

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