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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.

Author information

Koo T1, Lim DH2, Seol HJ3, Park CK4, Kim IH5, Chang JH6, Lee J7, Jung S8, Gwak HS9, Cho KH10, Hong CK11, Lee IJ12, Kim E13, Kim JH14, Hong YK15, Jang HS16, Kim CY17, Kim IA18, Kim SH19, Kim YI20, Kim EY21, Kim WC22, Hong S23.
1
Department of Radiation Oncology, Hallym University Sacred Heart Hospital, Anyang, South Korea.
2
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea. dh8lim@skku.edu.
3
Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
4
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea.
5
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea.
6
Department of Neurosurgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
7
Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
8
Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, South Korea.
9
Department of System Cancer Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea.
10
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, South Korea.
11
Department of Neurosurgery, Brain Tumor Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
12
Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
13
Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.
14
Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.
15
Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
16
Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
17
Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
18
Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
19
Department of Radiation Oncology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea.
20
Department of Radiation Oncology, Chungnam National University School of Medicine, Daejeon, South Korea.
21
Department of Neurosurgery, Inha University Hospital, Inha University of Medicine, Inchon, South Korea.
22
Department of Radiation Oncology, Inha University Hospital, Inha University of Medicine, Inchon, South Korea.
23
Department of Radiation Oncology, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, South Korea.