Comparison of short-course with long-course palliative radiotherapy for superior vena cava syndrome
Jongmoo Park,
Korea Republic of
PO-1328
Abstract
Comparison of short-course with long-course palliative radiotherapy for superior vena cava syndrome
Authors: Jongmoo Park1, Ji Hyeon Joo2, Jeong Eun Lee1
1School of Medicine, Kyungpook National University, Radiation Oncology, Daegu, Korea Republic of; 2Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Radiation Oncology, Yangsan, Korea Republic of
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Purpose or Objective
Superior vena cava (SVC) syndrome develops in 2 to 4 percent of patients with lung cancer and results from SVC obstruction by a primary tumor or mediastinal lymph nodes. Long-course (30 Gy in 10 fractions) palliative radiotherapy (RT) is an effective treatment for symptom relief. However, there have been only a only a few reported the efficacy of short-course (1-week) palliative RT, and no comparison of treatment outcomes according to the radiation course.
The aim of this study was to evaluate the treatment outcome of palliative RT for SVC syndrome from lung cancer, and to compare the effectiveness of short course and long course (2 and more-week) palliative RT schedule.
Material and Methods
We retrospectively reviewed patients with lung cancer who were treated with palliative RT to SVC syndrome between July 2012 and June 2020 at two institutions. A total of 33 patients with lung cancer who received palliative RT for SVC syndrome were identified. The treatment response and re-vascularization was evaluated based on the chest CT after RT. Treatment evaluated at 1 to 3 month after completion of palliative RT. Successful of re-vascularization was defined as a reduction of at least 20% points in the stenosis of at least one lesion, resulting in a residual stenosis of less than 50% of the luminal diameter.
Results
Of total 35 patients, 25 (71.4%) were non-small cell lung cancer and 10 (28.6%) were small cell lung cancer. The most frequently baseline symptoms were facial swelling (57.1%), dyspnea (42.9%), arm edema (11.4%), neck swelling (5.7%), hoarseness (5.7%) and orthopnea (2.9%).
The median radiation dose was 30 Gy (range, 8-42.5 Gy), with various fractionations (range, 2.5-8Gy). Of total 35 patients, 29 (82.9%) patients had symptom relief and 19 (54.3%) achieved SVC patency on follow-up chest CT. The response rates were higher in patients with small cell lung cancer, compared with patients with non-small cell lung (90.9% versus 40.9%, p=0.007). There were no statistically differences of the responses between patients receiving 30-42.5 Gy in 10-17 fractions and 20-25 Gy in 4-5 fractions.
Conclusion
Short- and long-course palliative radiotherapy for SVC syndrome from lung cancer were equally effective to relieve symptoms and no difference was seen in re-vascularization.