Uperior vena cava syndrome (svcs) was first described in l757 in a patient with a syphilitic



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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. 


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