The Korean Society for Neuro-Oncology (KSNO) Guideline for Glioblastomas: version 2018.01

Abstract

Background: There has been no practical guidelines for the management of patients with centralnervous system (CNS) tumors in Korea for many years. Thus, the Korean Society for Neuro-Oncology(KSNO), a multidisciplinary academic society, started to prepare guidelines for CNS tumors from February2018. Methods: The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRALusing specific and sensitive keywords as well as combinations of keywords. Results: First, the maximal safe resection if feasible is recommended. After the diagnosis of aglioblastoma with neurosurgical intervention, patients aged ≤70 years with good performance should betreated by concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide chemotherapy(Stupp’s protocol) or standard brain radiotherapy alone. However, those with poor performanceshould be treated by hypofractionated brain radiotherapy (preferred)±concurrent or adjuvanttemozolomide, temozolomide alone (Level III), or supportive treatment. Alternatively, patients aged >70years with good performance should be treated by hypofractionated brain radiotherapy+concurrentand adjuvant temozolomide or Stupp’s protocol or hypofractionated brain radiotherapy alone, whilethose with poor performance should be treated by hypofractionated brain radiotherapy alone or temozolomidechemotherapy if the patient has methylated MGMT gene promoter (Level III), or supportivetreatment. Conclusion: The KSNO’s guideline recommends that glioblastomas should be treated by maximalsafe resection, if feasible, followed by radiotherapy and/or chemotherapy according to the individualcomprehensive condition of the patient.