Palliative effectiveness of radiation therapy in the treatment of superior vena cava syndrome

Percutaneous treatment of superior vena cava syndrome using metallic stents

“…A treatment protocol has been described combining high doses of radiation and conventional treatment. A favourable result was found in between 66 and 94% of patients depending on the type of tumour [22]. Superior vena cava syndrome treated with radiation or chemotherapy recurs in 10-20% of the patients [23] and, since most patients receive maximum doses of radiotherapy or chemotherapy, the only possible treatment is medical or percutaneous.…”

“…In the SVCS caused by malignancy, radiotherapy and/or chemotherapy are considered the current standard for treatment [11,12]. Resolution rates published reaches more than 90% [13,14], although the majority of patients show regression of the obstruction after only a few days. Surgery has been reported for palliative treatment of SVCS in selected patients with a high rate of morbidity-mortality [15].…”

Double-flash, large-fraction radiation therapy as palliative treatment of malignant superior vena cava syndrome in the elderly

“…In two trials conducted by the Medical Research Council in the United Kingdom, a two-fraction (8.5 Gy ×2) RT schedule was shown to be feasible and an alternative to multifractionated regimens in terms of both survival and toxicity in advanced lung cancer patients [4,21]. More recently, other studies have confirmed the feasibility and effectiveness of hypofractionated RT regimens in the palliative setting, with doses up to 24 Gy in three fractions [8,14,15,16,20,31]. In order to maximize symptom control and minimize treatment-related discomfort, a policy of short-course, largefraction RT has been adopted in our centre for the treatment of older patients affected with solid malignancyrelated SVCS.…”

Radiation therapy in small cell lung cancer

“…One study randomized SVCS patients to initial CHT followed by further CHT or RT and found no difference [69]. In cases of SVCS, RT usually has included all locoregional disease and employed somewhat larger doses per fraction (on the order of 300 -400 cGy) [67,70], with fraction size increasing with decreasing performance status of patients [71].…”