|
Response to treatment.
The response to radiation in
most patients occurs within 3 to 4 days. Resolution of
facial edema and venous distension of the upper
extremities in addition to radiographic improvement
occur within 1 to 3 weeks. Radiation therapy is usually
not effective when thrombosis is causing the occlusion,
which emphasizes the importance of a complete and
thorough evaluation of the venous system in the diag-
nostic workup of SVCS. When radiation therapy is suc-
cessful, prolonged survival has been reported, especially
in cases in which full courses of treatment are complet-
ed. Of all patients with SVCS with malignancies, 10% to
20% survive more than 2 years.
Side effects.
Radiation therapy is associated with a
number of complications that include persistent fever,
bleeding or superior vena cava perforation at the site
of tumor invasion, nausea, vomiting, anorexia, leuko-
penia, hemoptysis, skin irritation, and esophagitis.
Pulmonary or mediastinal fibrosis may also occur as a
late complication.
5,8,9
Chemotherapy
Chemotherapy may be used as a primary therapy or
as an adjunct to radiotherapy for the treatment of
SVCS, depending on the underlying etiology of the
obstruction. The treatment of choice for SVCS caused
by mediastinal lymphoma is a combination of chemo-
therapy and radiotherapy.
Dostları ilə paylaş: | 
