SUPERIOR VENA CAVA SYNDROME
Differential Diagnosis
- 80% bronchogenic carcinoma
- 10-18% malignant lymphoma
- 2-3% benign cases (e.g., goiter)
Workup
Less Severe Syndrome and No Severe Respiratory Distress
- CT chest
- bronchoscopy
- biopsy of tumor
Full Blow SVC Syndrome and Severe Respiratory Distress
- emergency therapy without tissue diagnosis
- For unknown diagnosis assume NSCLC and start
- RT (3-4 Gy x 2-3 days) followed by 1.8-2.0 Gy to complete definitive RT (60-70 Gy)
- For patients with diagnosis of SCLC either RT or chemotherapy are effective
Prognosis
- 70% with either good or excellent symptomatic relieve of SVC syndrome with radiation
- OS-2 of 10-20%
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