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A National Consensus Survey for Current Practice in Brain Tumor Management I: Antiepileptic Drug and Steroid Usage

Brain Tumor Research and Treatment : BTRT 2020년 8권 1호 p.1 ~ 10
김승권, 문장섭, 조진모, 김경환, 김세훈, 김영일, 김영준, 김호성, Dho Yun-Sik, 박재성, 박지은, 서영범, Sung Kyoung-Su, 송진호, 위찬우, 윤완수, Yoon Hong-In, 이세훈, 임도훈, 임정호, 장종희, 한명훈, 홍제범, Hwang Ki-Hwan, 박철기, 이연수, 곽호신,
소속 상세정보
김승권 ( Kim Sung-Kwon ) - Gyeongsang National University Changwon Hospital Department of Neurosurgery
문장섭 ( Moon Jang-Sup ) - Seoul National University Hospital Department of Neurology
조진모 ( Cho Jin-Mo ) - Catholic Kwandong University International St. Mary’s Hospital Department of Neurosurgery
김경환 ( Kim Kyung-Hwan ) - Chungnam National University School of Medicine Chungnam National University Hospital Department of Neurosurgery
김세훈 ( Kim Se-Hoon ) - Yonsei University College of Medicine Severance Hospital Department of Pathology
김영일 ( Kim Young-Il ) - Catholic University College of Medicine St. Vincent’s Hospital Department of Neurosurgery
김영준 ( Kim Young-Zoon ) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Neurosurgery
김호성 ( Kim Ho-Sung ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
 ( Dho Yun-Sik ) - Chungbuk National University College of Medicine Chungbuk National University Hospital Department of Neurosurgery
박재성 ( Park Jae-Sung ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Neurosurgery
박지은 ( Park Ji-Eun ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
서영범 ( Seo Young-Beom ) - Yeungnam University Hospital Department of Neurosurgery
 ( Sung Kyoung-Su ) - Dong-A University College of Medicine Dong-A University Hospital Department of Neurosurgery
송진호 ( Song Jin-Ho ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiation Oncology
위찬우 ( Wee Chan-Woo ) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Radiation Oncology
윤완수 ( Yoon Wan-Soo ) - Catholic University College of Medicine Incheon St. Mary’s hospital Department of Neurosurgery
 ( Yoon Hong-In ) - Yonsei University College of Medicine Yonsei Cancer Center Department of Radiation Oncology
이세훈 ( Lee Se-Hoon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
임도훈 ( Lim Do-Hoon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
임정호 ( Im Jung-Ho ) - CHA University CHA Bundang Medical Center Department of Radiation Oncology
장종희 ( Chang Jong-Hee ) - Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
한명훈 ( Han Myung-Hoon ) - Hanyang University Guri Hospital Department of Neurosurgery
홍제범 ( Hong Je-Beom ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Neurosurgery
 ( Hwang Ki-Hwan ) - Seoul National University Bundang Hospital Department of Neurosurgery
박철기 ( Park Chul-Kee ) - Seoul National University College of Medicine Seoul National University Hospital Department of Neurosurgery
이연수 ( Lee Youn-Soo ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Hospital Pathology
곽호신 ( Gwak Ho-Shin ) - National Cancer Center Graduate School of Cancer Science and Policy Department of Cancer Control

Abstract


Background: The Guideline Working Group of the Korean Society for Neuro-Oncology (KSNO) conducted a nationwide questionnaire survey for diverse queries faced in the treatment of brain tumors. As part I of the survey, the aim of this study is to evaluate national patterns of clinical practice about antiepileptic drug (AED) and steroid usage for management of brain tumors.

Methods: A web-based survey was sent to all members of the KSNO by email. The survey included 9 questions of AED usage and 5 questions of steroid usage for brain tumor patients. All questions were developed by consensus of the Guideline Working Group.

Results: The overall response rate was 12.8% (54/423). Regarding AED usage, the majority of respondents (95.2%) routinely prescribed prophylactic AEDs for patients with seizure at the peri/postoperative period. However, as many as 72.8% of respondents prescribed AED routinely for seizure-naive patients, and others prescribed AED as the case may be. The duration of AED prophylaxis showed wide variance according to the epilepsy status and the location of tumor. Levetiracetam (82.9%) was the most preferred AED for epilepsy prophylaxis. Regarding steroid usage, 90.5% of respondents use steroids in perioperative period, including 34.2% of them as a routine manner. Presence of peritumoral edema (90.9%) was considered as the most important factor determining steroid usage followed by degree of clinical symptoms (60.6%). More than half of respondents (51.2%) replied to discontinue the steroids within a week after surgery if there are no specific medical conditions, while 7.3% preferred slow tapering up to a month after surgery.

Conclusion: The survey demonstrated the prevailing practice patterns on AED and steroid usage in neuro-oncologic field among members of the KSNO. This information provides a point of reference for establishing a practical guideline in the management of brain tumor patients.

키워드

Korean Society for Neuro-Oncology; Practice patterns; Brain tumors; Antiepileptic drugs; Steroids, Guideline Working Group

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