Double-flash, large-fraction radiation therapy as palliative treatment of malignant superior vena cava syndrome in the elderly
Double-flash, large-fraction radiation therapy as palliative treatment of malignant superior vena cava syndrome in the elderly
复制标题
DOI：
10.1007/s00520-001-0313-4
复制
发表时间：
2002-03-01
影响因子：
3.1
通讯作者：
Campostrini, F
中科院分区：
文献类型：
--
作者：
Lonardi, F;Gioga, G;Campostrini, F
在癌症引起的上级腔静脉综合征（SVCS）中，必须迅速控制症状，但老年患者通常不能耐受积极的方法。为了最大限度地缓解症状，并尽量减少治疗相关的不适，老年患者在健康状况不佳，我们采用了短程，大分割放射治疗（RT）的时间表。连续23例年龄超过70岁的患有实体恶性肿瘤相关SVCS的患者入组。总剂量为12戈伊，分两次6-戈伊，间隔1周，主要在门诊进行。计划对反应最好的患者完成37-40戈伊的治疗。8例患者在第一次治疗后4-5天症状缓解。总有效率为87%。尽管有5名患者（22%）报告了一些轻微的全身副作用（胸痛、发热），但总体毒性可忽略不计。短程双闪RT是姑息治疗老年恶性上腔静脉综合征的有效和安全的工具。可以避免大于6戈伊的剂量，以尽量减少副作用和毒性作用。
Rapid control of symptoms is mandatory in cancer-induced superior vena cava syndrome (SVCS), but older patients often do not tolerate aggressive approaches. In order to maximize symptom relief and minimize treatment-related discomfort of aged patients in poor health we adopted a short-course, large-fraction radiation therapy (RT) schedule. Twenty-three consecutive patients aged over 70 who were suffering from solid-malignancy-related SVCS were enrolled. A total dose of 12 Gy was given in two 6-Gy fractions, I week apart, mainly in an outpatient setting. Completion of therapy to give up to 37-40 Gy was planned in the best-responding padents. Symptom relief was experienced by 8 patients as early as 4-5 days after the first fraction. The overall response rate was 87%. Despite some mild systemic side effects (chest pain, fever) reported by 5 patients (22%), overall toxicity was negligible. Short-course, double-flash RT stands as an effective and safe tool in the palliative treatment of malignant SVCS in older patients. Fractions larger than 6 Gy can be avoided in order to minimize side and toxic effects.