[Treatment of the superior vena cava syndrome]

The author describes the results of therapy in three groups of patients (128 patients altogether) with the superior vena cava syndrome caused by a tumorous disease. All the patients were treated by radiotherapy as a main method of therapy. (200 kV, filtration 2 mm Cu) in a daily fractionation 300 r on the surface by one field, in the second period (1974-1978) 55 patients were irradiated by 60Co cobalt from two opposite fields by daily fractionation of 170-180 rad into the focus and in the third period (1984-1986) 25 patients were irradiated by 60Co cobalt from two opposite fields in 3-4 introductory daily fractions 3.0 Gy into the focus and then in normal fractionation up to the total dose planned. Immediate results of the treatment--complete disappearance of the syndrome symptoms--were the best in the 3rd group, where a complete disappearance of the symptoms was observed in 84% of patients and a partial relief in 8%. In the first period a complete disappearance of symptoms was in 54% and a partial relief in 10% of patients. The corresponding values in the second period were 74% and 11% respectively. In evaluating the survival of patients, no significant differences were found. In the first period, 50% of patients survived 12 weeks, in the second period 16 weeks and in the third one 20 weeks. One-year survival was reached by two per cent of patients in the first period, four per cent in the second period and eight per cent in the third period. The paper discusses other therapeutic possibilities and approaches in the treatment of the superior vena cava syndrome.