A National Consensus Survey for Current Practice in Brain Tumor Management I: Antiepileptic Drug and Steroid Usage
Authors
Sung Kwon Kim ; Jangsup Moon ; Jin Mo Cho ; Kyung Hwan Kim ; Se Hoon Kim ; Young Il Kim ; Young Zoon Kim ; Ho Sung Kim ; Yun Sik Dho ; Jae Sung Park ; Ji Eun Park ; Youngbeom Seo ; Kyoung Su Sung ; Jin Ho Song ; Chan Woo Wee ; Wan Soo Yoon ; Hong In Yoon ; Se Hoon Lee ; Do Hoon Lim ; Jung Ho Im ; Jong Hee Chang ; Myung Hoon Han ; Je Beom Hong ; Kihwan Hwang ; Chul Kee Park ; Youn Soo Lee ; Ho Shin Gwak ; KSNO Guideline Working Group
Citation
Brain Tumor Research and Treatment, Vol.8(1) : 1-10, 2020-04
Antiepileptic drugs ; Brain tumors ; Korean Society for Neuro-Oncology ; Practice patterns ; Steroids, Guideline Working Group
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-naïve 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.