Unfortunately, chemotherapeutic agents which are effective against primary solid tumors are seldom as effective against brain metastases. The blood-brain barrier is partly responsible but other factors are likely to contribute, as lipid soluble agents are also ineffective, the blood-brain barrier around most metastastic lesions is deficient and intrathecal or intraven-tricular injection does not significantly improve outcome. However, chemotherapy of cerebral metastases of some histologies, including breast cancer, small cell lung carcinoma and choriocarcinoma, can effect remission, stabilize neurologic deficits and prolong median survival. The current role for chemotherapy of cerebral metastases is limited to adjuvant treatment of such chemosensitive tumors. Improvements in the delivery of drugs to the CNS and new multiagent regimens may broaden the role of chemotherapy in the future.
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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.