Radiation therapy following biopsy or resection for HGGs is the most effective adjuvant treatment modality available. It is generally administered in 180 cGy fractions to a total dose of around 60 Gy when treating the bulk tumor plus a margin that encompasses the area of increased T2 signal. In a randomized trial of anaplastic glioma patients, the overall survival of patients treated with "best conventional care", BCNU alone, radiation alone, and radiation plus BCNU was 17 weeks, 18.5 weeks, 37.5 weeks and 40.5 weeks, respectively [16]. This beneficial effect of radiation on survival applies to other HGGs and GBM as well. The efficacy of radiation has been further validated for HGG by the demonstration of a dose-response relationship. Accordingly, external beam irradiation has become standard therapy for HGG patients after biopsy or resection. In addition, an objective radiographic response to radiation is also an independent predictor of prolonged overall survival for patients with GBM. Thus, the uniformity and adequacy of radiation treatment must

Table 10.2. Survival for HGGs by RTOG RPA (courtesy of Curan et al. [12])

RPA class

Median survival

2-year survival

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

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.

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