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Double-flash, large-fraction radiation therapy as palliative treatment of malignant superior vena cava syndrome in the elderly

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Abstract

Rapid control of symptoms is mandatory in cancer-induced superior vena cava syndrome (SVCS), but older patients often do not tolerate aggressive approaches. In order to maximize symptom relief and minimize treatment-related discomfort of aged patients in poor health we adopted a short-course, large-fraction radiation therapy (RT) schedule. Twenty-three consecutive patients aged over 70 who were suffering from solid-malignancy-related SVCS were enrolled. A total dose of 12 Gy was given in two 6-Gy fractions, 1 week apart, mainly in an out-patient setting. Completion of therapy to give up to 37–40 Gy was planned in the best-responding patients. Symptom relief was experienced by 8 patients as early as 4–5 days after the first fraction. The overall response rate was 87%. Despite some mild systemic side effects (chest pain, fever) reported by 5 patients (22%), overall toxicity was negligible. Short-course, double-flash RT stands as an effective and safe tool in the palliative treatment of malignant SVCS in older patients. Fractions larger than 6 Gy can be avoided in order to minimize side and toxic effects.

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Lonardi, F., Gioga, G., Agus, G. et al. Double-flash, large-fraction radiation therapy as palliative treatment of malignant superior vena cava syndrome in the elderly. Support Care Cancer 10, 156–160 (2002). https://doi.org/10.1007/s00520-001-0313-4

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  • DOI: https://doi.org/10.1007/s00520-001-0313-4

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