Unveiling Indonesia's Neurooncology Landscape: Progress and Challenges

Indonesia, an expansive archipelago with over 17,000 islands, is not only the world's largest island country but also home to a complex healthcare landscape. With 38 provinces and a population of 278.69 million, the nation faces the challenges posed by cancer, registering 396,914 new cases and 234,511 deaths. Within this context, the field of neurooncology has emerged as a crucial area of focus. In the realm of neurooncology, brain tumors hold a significant presence in Indonesia, affecting 32-43% of males and 57-68% of females, primarily striking individuals aged 44-52. The prevalent types include Meningioma (25-77.1%), astrocytoma, and pituitary adenoma.

Indonesia has 16 neurooncology centers distributed across the nation, supported by a network of healthcare professionals. As of April 2023, there are 469 neurosurgeons, 2538 neurologists, 17 neurooncologists, 139 medical oncologists, 958 pathologists, 8 neuropathologists, 1646 radiologists, 28 neuroradiologists, and 150 radiotherapists. The growth in neurologists specializing in neurooncology has been notable, increasing from 7 in 2020 to 17 in 2023. Treatment modalities available encompass surgery, radiotherapy, radiosurgery, systemic therapy, and palliative care, supported by advanced radiology modalities and neurosurgical techniques.

The collaborative efforts extend beyond individual expertise, as evidenced by the formation of the Indonesian Society of Neurooncology (InaSNO) in 2015, with membership across 10 different fields. InaSNO actively participates in international collaborations, having joined the Asian Society for Neuro-Oncology (ASNO) in the same year.

The neurooncology community engages in various initiatives, including multidisciplinary discussions through Clinicopathological Conferences (CPC) and multicentre collaborations for community service, notably during events such as World Brain Tumor Day. A recent multicentre research project on the clinical and molecular profile of glioma in Indonesia revealed important findings, such as a 35.7% prevalence of IDH mutation and 48.6% methylation of the MGMT promoter in glioma patients.

Despite progress, challenges persist, including uneven distribution of healthcare resources and limited access to government insurance in remote areas. The need for comprehensive studies, clinical trials, and health promotion initiatives remains crucial to further advancements.

Moving forward, Indonesia is set for growth in the neurooncology field, fueled by optimism and a commitment to international collaboration. The aim is not only to provide the best possible treatments for patients but also to contribute to the global advancement of neurooncology. With challenges acknowledged and a proactive spirit, Indonesia's neurooncology community is determined to make significant progress in the journey ahead.