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The Journal of the Korean Society for Therapeutic Radiology and Oncology 2005;23(2): 78-84. |
| Radiation Therapy for Superior Vena Cava Syndrome |
| Jin Hee Kim |
| Department of Radiation Oncology, Keimyung University School of Medicine, Daegu, Korea. jhkim@dsmc.or.kr |
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| ABSTRACT |
PURPOSE:
We studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS).
MATERIALS AND METHODS:
From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-rays and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy. The follow-up periods were from 1 to 180 months with a median of 5.6 months.
RESULTS:
The main clinical manifestations were dyspnea (84.7%), facial edema (81.9%), arm edema (22.2%), neck vein distension (25%), hoarseness (12.5%) and facial plethora (5.6%). Eighty percent of patients achieved excellent to good symptom improvement and 19.4% experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were 17.7% at 2 years (2YOS) and 14.8% at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, 16.7% and 13.4% for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR;>30 Gy, 25.6%, < or =30 Gy 6.7%, p<0.01). On the multivariated analysis, a higher total tumor dose (p<0.01) and younger age (p<0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant (p>0.05).
CONCLUSION:
Radiation therapy for the patients with SVCS due to malignancy could be an effective treatment. We considered that radiation therapy above 30 Gy of the total tumor dose may improve survival for SVCS due to lung cancer. |
| Key Words:
Superior vena cava syndrome, Radiation therapy, Survival rate, Prognostic factor, Lung cancer |
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