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上腔静脉综合征属急症,引起病人严重的不适,需紧急处理,若不治疗预后很差,若积极处理,大约25％病人存活至少一年。大约75％由支气管肺癌引起(特别是小细胞癌),恶性淋巴瘤占10％,放疗对几乎所有的上腔静脉综合症有效,特别是位于胸腔内的肿瘤。作者回顾性分析了125例,平均年龄55岁,男∶女∶2.8:1。大多数为Ⅲ期支气管肺癌,恶性淋巴瘤占14%,肿癌中42％为小细胞肺癌。呼吸困难占55％,面部、躯干、上臂水肿者占1/3。最常用的诊断方法是支气管镜检查并取活检。开始用高剂量放疗(300—400cGy/日,3次/周)与常规放疗相比症状缓解程度相似。全组平均存活5.5个月,1年存活率24％,2年为9％,存活率与组织学关系密切,如恶性淋巴瘤一年存活
Superior vena cava syndrome is an emergency and causes serious discomfort to the patient. Emergency treatment is required. If the prognosis is not poor, approximately 25% of patients survive at least one year if actively treated. About 75% is caused by bronchial lung cancer (especially small cell carcinoma), malignant lymphoma accounts for 10%, and radiotherapy is effective for almost all superior vena cava syndromes, especially those located within the thoracic cavity. The author retrospectively analyzed 125 cases, with an average age of 55 years and men and women: 2.8:1. Most of them are stage III bronchiolar carcinomas, malignant lymphomas account for 14%, and 42% of tumors are small cell lung cancers. Difficulties in breathing accounted for 55%, and 1/3 of face, trunk, and upper arm edema. The most common diagnostic method is bronchoscopy and biopsy. The use of high-dose radiation therapy (300-400 cGy/day, 3 times/week) started with a similar degree of symptomatic relief compared to conventional radiotherapy. The average survival time of the whole group was 5.5 months. The one-year survival rate was 24%, and the two-year survival rate was 9%. The survival rate was closely related to histology. For example, malignant lymphoma survived for one year.