HYPOFRACTIONATED RADIATION-THERAPY IN THE TREATMENT OF SUPERIOR VENA-CAVA SYNDROME

We retrospectively reviewed 46 patients with superior vena cava syndro me during the period 1986-1992. The common symptoms included congestio n of collateral veins of the neck, anterior chest wall, face, eyelids and right arm. Dyspoea and cyanosis occurred less frequently. In all b ut two patients a histological diagnosis was made by invasive and non- invasive examination without complications. In 82% of all patients a p rimary lung carcinoma was the cause of the superior vena cava syndrome . For 39 patients radiotherapy was the first treatment of choice. To r elieve the distressing symptoms patients received one of two regimens employing hypofractionated radiotherapy. In regimen 3F, 25 patients re ceived three weekly high dose fractions of 8 Gy delivering a total dos e of 24 Gy. Regimen 2F, applied to seven patients, consisted of two we ekly fractions of 8 Gy, giving a total of 24 Gy. In both regimens a go od palliative result was established, however the results of the 3F re gimen were superior. Using the 3F regimen a partial response was obtai ned in 96% of all patients, and 56% achieved a complete response. With the 2F regimen a partial response was achieved in 70% of all patients , and a complete response in only 28%. Minimal side effects were noted . After reviewing our experience, the 3F regimen is recommended for ra pid and effective relief of the superior vena cava syndrome.