Kim Sung Kwon, Park Ji Eun, Kim Kyung Hwan, Cho Jin Mo, Moon Jangsup, Yoon Wan Soo, Kim Se Hoon, Kim Young Il, Kim Young Zoon, Kim Ho Sung, Dho Yun Sik, Park Jae Sung, Yoon Hong In, Seo Youngbeom, Sung Kyoung Su, Song Jin Ho, Wee Chan Woo, Lee Se Hoon, Lim Do Hoon, Im Jung Ho, Chang Jong Hee, Han Myung Hoon, Hong Je Beom, Hwang Kihwan, Park Chul Kee, Lee Youn Soo, Gwak Ho Shin
Department of Neurosurgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Brain Tumor Res Treat. 2020 Apr;8(1):20-28. doi: 10.14791/btrt.2020.8.e7.
The Guideline Working Group of the Korean Society for Neuro-Oncology (KSNO) conducted the nationwide questionnaire survey for diverse queries facing to treat patients with brain tumor. As part III of the survey, the aim of this study is to evaluate the national patterns of clinical practice for patients with brain metastasis and primary central nervous system lymphoma (PCNSL).
A web-based survey was sent to all members of the KSNO by email. The survey included 7 questions of brain metastasis and 5 questions of PCNSL, focused on the management strategies in specific situations. All questions were developed by consensus of the Guideline Working Group.
In the survey about brain metastasis, respondents preferred surgical resection with adjuvant treatment for patients with a surgically accessible single brain metastatic lesion less than 3 cm in size without extracranial systemic lesions. However, most respondents considered radiosurgery for surgically inaccessible lesions. As the preferred treatment of multiple brain metastases according to the number of brain lesions, respondents tended to choose radiotherapy with increasing number of lesions. Radiosurgery was mostly chosen for the brain metastases of less than or equal to 4. In the survey about PCNSL, a half of respondents choose high-dose methotrexate-based polychemotherapy as the first-line induction therapy for PCNSL. The consolidation and salvage therapy showed a little variation among respondents. For PCNSL patients with cerebrospinal fluid dissemination, intrathecal chemotherapy was most preferred.
The survey demonstrates the prevailing clinical practice patterns for patients with brain metastasis and PCNSL among members of the KSNO. This information provides a point of reference for establishing a practical guideline in the management of brain metastasis and PCNSL.
韩国神经肿瘤学会（KSNO）指南工作组针对脑肿瘤患者治疗中面临的各种问题开展了全国性问卷调查。作为该调查的第三部分，本研究旨在评估脑转移瘤和原发性中枢神经系统淋巴瘤（PCNSL）患者的全国临床实践模式。
通过电子邮件向KSNO的所有成员发送了基于网络的调查问卷。该调查包括7个关于脑转移瘤的问题和5个关于PCNSL的问题，重点关注特定情况下的管理策略。所有问题均由指南工作组协商制定。
在关于脑转移瘤的调查中，对于单个脑转移瘤大小小于3 cm且无颅外系统性病变、可通过手术切除的患者，受访者倾向于选择手术切除并辅助治疗。然而，大多数受访者认为对于无法手术切除的病变应采用立体定向放射治疗。根据脑转移瘤的数量，作为多发性脑转移瘤的首选治疗方法，随着病变数量的增加，受访者倾向于选择放射治疗。对于4个及以下的脑转移瘤，大多选择立体定向放射治疗。在关于PCNSL的调查中，一半的受访者选择以大剂量甲氨蝶呤为基础的多药联合化疗作为PCNSL的一线诱导治疗。巩固治疗和挽救治疗在受访者中显示出略有差异。对于脑脊液播散的PCNSL患者，鞘内化疗是最首选的治疗方法。
该调查展示了KSNO成员中脑转移瘤和PCNSL患者普遍的临床实践模式。这些信息为制定脑转移瘤和PCNSL管理的实用指南提供了参考依据。
