[Chemoradiation treatment of the superior vena cava compression syndrome in small-cell lung cancer].
1988
The superior vena cava compression syndrome (SVCCS) was detected in 340 patients with small cell lung carcinoma (SCLC): in 44--during establishing primary diagnosis (the primary syndrome), in 10--after courses of chemo- or radiotherapy (the secondary syndrome). In 32 patients with the primary SVCCS therapy was started with chemotherapy courses, a complete clinical effect was noted in 20 (62.5%) of them, on an average, in 11.7 days. Radiotherapy or chemo- and radiotherapy were given to 32 patients: to 12 patients as kind of primary therapy, to 12 patients after a partial effect of chemotherapy, and to 8 patients with the secondary SVCCS. A complete clinical effect was noted in 28 (87.5%) patients, on an average, in 23 days. Complete and partial tumor regressions (an objective effect) were noted in 30% of the patients after chemotherapy and in 75%--after radiotherapy or chemo- and radiotherapy. Marked responses to therapy were noted in single administration of chemotherapeutic drugs at large doses (leukopenia below 2000 cells/microliter, vomiting) or in irradiation of the thoracic cavity at single doses of 3-6 Gy (esophagitis). The authors recommended to plan chemo- and radiotherapy at mean doses in patients with the primary SVCCS, in a localized process or distant metastases, not threatening the patient's life. In the secondary SVCCS developing after chemotherapy, a method of choice is radiotherapy using single doses of 4-6 Gy, 5-8 fractions.
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