SUPERIOR VENA-CAVA SYNDROME (SVCS) IN SMALL-CELL LUNG-CANCER - A PROGNOSTIC FACTOR

One hundred and thirty-three unselected patients with small cell cancer of the lung were retrospectively analyzed. They were consecutively treated between January 1985 and December 1990 in the Department of Radiation Oncology of the University of Wuerzburg. An analysis was performed of 25 patients presenting with superior vena cava syndrom (SVCS) in comparison to 108 patients without SVCS to answer the following questions: 1. Which are the patients characteristics? 2. What kind of metastatic disease was developed? 3. What kind of treatment did these patients receive and how did they respond to it? 4. What was the prognosis of these patients? The patients with SVCS were treated as follows: 16% only by irradiation and 16% only by chemotherapy, and 64% received a combined radiochemothempy. The median follow-up time was 10.5 months (0.3 to 77.5 months). The primary tumor was located in the right lung in 92% of patients with SVCS.48% were staged as ''limited disease''. 52% of patients with SVCS had distant disease at primary diagnosis. 64% developed distant metastasis during the course of disease. The patients characteristics for cases with and without SVCS were quite similar. 90% of the SVCS-patients showed a favorable response to treatment. The kind of treatment influenced the survival time: only patients with combined radiochemotherapy survived longer than 20 months. SVCS is not an unfavourable prognostic factor: no statistical difference in survival for patients with and without SVCS was noted. We strongly recommend a combined radiochemotherapy for patients with SVCS.