PDF(Pubmed)
Abstract：
BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, the need for appropriate treatment guidelines for patients with brain tumors was indispensable due to the lack and limitations of medical resources. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has undertaken efforts to develop a guideline that is tailored to the domestic situation and that can be used in similar crisis situations in the future.
METHODS: The KSNO Guideline Working Group was composed of 22 multidisciplinary experts on neuro-oncology in Korea. In order to reach consensus among the experts, the Delphi method was used to build up the final recommendations.
RESULTS: All participating experts completed the series of surveys, and the results of final survey were used to draft the current consensus recommendations. Priority levels of surgery and radiotherapy during crises were proposed using appropriate time window-based criteria for management outcome. The highest priority for surgery is assigned to patients who are life-threatening or have a risk of significant impact on a patient\'s prognosis unless immediate intervention is given within 24-48 hours. As for the radiotherapy, patients who are at risk of compromising their overall survival or neurological status within 4-6 weeks are assigned to the highest priority. Curative-intent chemotherapy has the highest priority, followed by neoadjuvant/adjuvant and palliative chemotherapy during a crisis period. Telemedicine should be actively considered as a management tool for brain tumor patients during the mass infection crises such as the COVID-19 pandemic.
CONCLUSIONS: It is crucial that adequate medical care for patients with brain tumors is maintained and provided, even during times of crisis. This guideline will serve as a valuable resource, assisting in the delivery of treatment to brain tumor patients in the event of any future crisis.
METHODS: The KSNO Guideline Working Group was composed of 22 multidisciplinary experts on neuro-oncology in Korea. In order to reach consensus among the experts, the Delphi method was used to build up the final recommendations.
RESULTS: All participating experts completed the series of surveys, and the results of final survey were used to draft the current consensus recommendations. Priority levels of surgery and radiotherapy during crises were proposed using appropriate time window-based criteria for management outcome. The highest priority for surgery is assigned to patients who are life-threatening or have a risk of significant impact on a patient\'s prognosis unless immediate intervention is given within 24-48 hours. As for the radiotherapy, patients who are at risk of compromising their overall survival or neurological status within 4-6 weeks are assigned to the highest priority. Curative-intent chemotherapy has the highest priority, followed by neoadjuvant/adjuvant and palliative chemotherapy during a crisis period. Telemedicine should be actively considered as a management tool for brain tumor patients during the mass infection crises such as the COVID-19 pandemic.
CONCLUSIONS: It is crucial that adequate medical care for patients with brain tumors is maintained and provided, even during times of crisis. This guideline will serve as a valuable resource, assisting in the delivery of treatment to brain tumor patients in the event of any future crisis.
摘要：
背景：在2019年冠状病毒病（COVID-19）大流行期间，由于医疗资源的缺乏和限制,脑肿瘤患者需要适当的治疗指南是不可或缺的.因此，韩国神经肿瘤学会（KSNO），一个多学科的学术协会，努力制定适合国内局势的指导方针，并可在未来类似的危机局势中使用。
方法：KSNO指南工作组由22名韩国神经肿瘤学多学科专家组成。为了在专家之间达成共识，采用德尔菲法建立最终建议。
结果：所有参与的专家都完成了系列调查，最后调查结果被用来起草目前的共识建议。使用适当的基于时间窗口的管理结果标准，提出了危机期间手术和放疗的优先级别。除非在24-48小时内立即进行干预，否则危及生命或对患者预后有重大影响的患者应优先进行手术。至于放疗,在4~6周内有降低总生存期或神经系统状态风险的患者被分配至最优先.治疗性化疗是最优先的，随后在危机期间进行新辅助/辅助和姑息化疗。在COVID-19大流行等大规模感染危机期间，应积极考虑将远程医疗作为脑肿瘤患者的管理工具。
结论：维持和提供脑肿瘤患者的适当医疗护理至关重要，即使在危机时期。这个准则将作为一个宝贵的资源，在未来发生任何危机时，协助向脑肿瘤患者提供治疗。
方法：KSNO指南工作组由22名韩国神经肿瘤学多学科专家组成。为了在专家之间达成共识，采用德尔菲法建立最终建议。
结果：所有参与的专家都完成了系列调查，最后调查结果被用来起草目前的共识建议。使用适当的基于时间窗口的管理结果标准，提出了危机期间手术和放疗的优先级别。除非在24-48小时内立即进行干预，否则危及生命或对患者预后有重大影响的患者应优先进行手术。至于放疗,在4~6周内有降低总生存期或神经系统状态风险的患者被分配至最优先.治疗性化疗是最优先的，随后在危机期间进行新辅助/辅助和姑息化疗。在COVID-19大流行等大规模感染危机期间，应积极考虑将远程医疗作为脑肿瘤患者的管理工具。
结论：维持和提供脑肿瘤患者的适当医疗护理至关重要，即使在危机时期。这个准则将作为一个宝贵的资源，在未来发生任何危机时，协助向脑肿瘤患者提供治疗。
