The deleterious effect of radiation has been mentioned above and no study has convincingly demonstrated a beneficial effect of radiation therapy on survival or neurological function for low-grade tumors. Although some authors still recommend radiotherapy for intramedullary spinal cord tumors, no study has been performed comparing the effects of radiation therapy for intramedullary neoplasms. Thus, these tumors should be recognized as a surgical disease, both at presentation and at time of recurrence. Stein also did not recommend radiotherapy for adult patients with low-grade intramedullary neoplasms, regardless of the extent of removal, and emphasized the deleterious effects of radiation on the spinal cord tissue adjacent to the tumor site. The results are similar to others who have reported myelopathy in children who have received doses of 30 Gy. Thus radiation therapy is reserved for patients with malignant tumors, those with documented post-operative rapid tumor regrowth or for those with substantial residual tumor who are not candidates for further surgery. Intra-medullary ependymomas should be resected and radiotherapy is not an option for these patients.
We employ total neuraxis radiation for the malignant tumors. Unfortunately, it has been shown that glioblastomas invariably progress. Despite aggressive radiotherapy and
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.