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Evidence summaries

Steroids, Radiotherapy, Chemotherapy and Stents for Superior Vena Caval Obstruction in Carcinoma of the Bronchus

Chemotherapy and radiotherapy are effective in relieving superior vena caval obstruction (SVCO), but stent insertion may be even more effective. Level of evidence: "A"

A Cochrane review [Abstract] 1 [withdrawn from publication] included 2 randomised studies and 44 non-randomised studies that met the inclusion criteria. Superior vena caval obstruction was present at diagnosis in 10.0% of patients with small cell lung carcinoma (SCLC) and 1.7% of patients with non-small cell lung carcinoma (NSCLC). In SCLC, chemotherapy and/or radiotherapy relieved SVCO in 77%, but 17% had a relapse. In NSCLC, 60% had relief of SVCO, but 19% had a relapse. Insertion of a superior vena caval stent relieved SVCO in 95%; 11% relapsed but recanalisation was possible in the majority resulting in a long-term patency rate of 92%. There were no randomised trials on steroids.

    References

    • Rowell NP, Gleeson FV. WITHDRAWN: Steroids, radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus. Cochrane Database Syst Rev 2015;(3):CD001316. [PubMed]

Primary/Secondary Keywords