I have a 35 yo male who is not doing well after posterior fossa surgery/infections/hydrocephalus for adult medulloblastoma. He is trached, nonverbal, has a decubitus ulcer, fevers, and a KPS probably of 20-30. He needs CSI 36 Gy and boost. He is barely following commands 30+ days from surgery and very slowly improving. I am torn ethically about what to do. Any guidance or thoughts on when to initiate radiation if ever?