ROLE OF IRRADIATION IN THE MANAGEMENT OF SUPERIOR VENA-CAVA SYNDROME
ROLE OF IRRADIATION IN THE MANAGEMENT OF SUPERIOR VENA-CAVA SYNDROME
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DOI：
10.1016/0360-3016(87)90068-x
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发表时间：
1987-04-01
影响因子：
7
通讯作者：
HEDERMAN, MA
中科院分区：
文献类型：
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作者：
ARMSTRONG, BA;PEREZ, CA;HEDERMAN, MA
回顾性分析125例恶性肿瘤所致上级腔静脉综合征患者的临床资料。患者的平均年龄为55岁。支气管癌占79%，恶性淋巴瘤占18%，其他肿瘤占6%。大约80%的患者获得了良好至极好的症状缓解。高初始剂量放射治疗（300-400 cGy，每日3次）在70%的患者中在不到2周的时间内产生了良好的症状缓解;常规剂量放射治疗（200 cGy，每日5次，每周1次）在56%的患者中产生了相同的反应（p = 0.09）。淋巴瘤患者的1年生存率为41%，小细胞癌为24%，其他类型的支气管肺癌为17%。放疗和化疗的结合并没有提高反应率、症状缓解程度或长期生存率。在30天内症状缓解的患者的生存率显著高于未缓解的患者（p = 0.002）。13%的患者出现上级腔静脉综合征复发。肿瘤消退与症状缓解之间无相关性。治疗的副作用很小;吞咽困难是最常见的主诉（26%的患者）。
The records of 125 patients treated for superior vena cava syndrome to malignant disease were reviewed retrospectively. The mean age of patients was 55 years. Bronchogenic carcinoma was the cause of the syndrome in 79% of cases, malignant lymphoma 18%, and other tumors 6%. Approximately 80% of the patients obtained good to excellent symptomatic relief. High initial dose radiation therapy (300-400 cGy daily for three fractions) yielded good symptomatic relief in less than 2 weeks in 70% of patients; conventional dose radiation therapy (200 cGy daily, five weekly fractions) yielded the same response in 56% of patients (p = 0.09). Lymphoma patients displayed a 1 year survival of 41%, small cell carcinoma 24%, and other types of bronchogenic carcinoma 17%. Combination of radiation and chemotherapy did not improve response rate, degree of symptomatic relief or long-term survival. Patients exhibiting symptomatic relief within 30 days had a significantly better survival rate than those who did not (p = 0.002). Thirteen percent of patients showed a recurrence of superior vena cava syndrome. There was no correlation between tumor regression and symptomatic relief. Side effects of therapy were minimal; dysphagia was the most common complaint (26% of patients).