CLINICAL OUTCOME OF STENTING IN SUPERIOR VENA-CAVA SYNDROME-ASSOCIATED WITH MALIGNANT-TUMORS - COMPARISON WITH CONVENTIONAL TREATMENT

Purpose. We analyzed the clinical outcome of treatment with the expand able metallic stent (EMS) for the superior vena cava (SVC) syndrome as sociated with malignant tumors, and the results were compared with tho se of radiotherapy. Material and Methods: Of 33 patients with the SVC syndrome, 23 were treated by Gianturco EMS placement and 10 were treat ed by radiotherapy and/or chemotherapy alone. Of the 23 EMS patients, 11 had treatment before EMS placement and 12 had no treatment before E MS placement. Results: After stenting, the clinical symptoms disappear ed in 78% (18/23) of the patients, i.e. in 50% of the patients with in traluminal tumors, and in 93% of those with extrinsic compression. The clinical symptoms improved in 80% of patients who received radiothera py. The mean duration of survival was 145 days in patients who underwe nt stenting, and 146 days in those receiving radiotherapy. However, th e survival period differed significantly between patients with intralu minal tumors (44.9 days) and those with extrinsic compression (198.6 d ays). Between patients with previous treatment and those with no previ ous treatment, there was no significant difference in response rate or in survival period which were 82% versus 75%, and 127 days versus 162 days, respectively Conclusion. The clinical symptoms showed similar i mprovement in patients receiving EMS placement or radiotherapy. EMS pl acement was effective in relieving clinical symptoms in patients who h ad failed to respond to radiotherapy.