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March 2, 1984

Treatment of Superior Vena Cava Syndrome

Author Affiliations

Los Angeles

JAMA. 1984;251(9):1162. doi:10.1001/jama.1984.03340330024014

To the Editor.—  We are writing in response to the BRIEF REPORT entitled "Superior Vena Cava Syndrome due to Non-Small-cell Lung Cancer" by Citron et al.1 These authors report successful therapy for the superior vena cava (SVC) syndrome in their patients using combined chemotherapy. It has been reported that cisplatin regimens, as used in this report, can lead to responses in approximately 40% to 50% of treated patients.2,3 This is certainly far less than the reported effectiveness of radiation therapy, which has a reported response rate of 80% to 90% in patients with the SVC syndrome.4Although the report by Citron et al is of interest, a comparison of these disparate forms of treatment for SVC syndrome remains to be properly studied in patients with non-small-cell lung cancer.On the basis of this brief report, we believe that great caution should be observed. From the available studies

Citron ML, Fossieck BE, Krasnow SH, et al:  Superior vena cava syndrome due to non-small-cell lung cancer .  JAMA 1983;250:71-72.Crossref
Woodcock TM, Blumenreich MS, Richman SP, et al:  Combination chemotherapy with cis-diamminedichloroplatinum and vinblastine in advanced non-small-cell lung cancer .  J Clin Oncol 1983;1:247-250.
Gralla RJ, Casper ES, Kelsen DP, et al:  Cisplatin and vindesine combination chemotherapy for advanced carcinoma of the lung: A randomized trial investigating two dosage schedules .  Ann Intern Med 1981;95:414-420.Crossref
Perez CA, Presant CA, van Amburg AL III:  Management of the superior vena cava syndrome .  Semin Oncol 1978;5:123-128.