Sequential treatment of superior vena cava syndrome caused by of non-small cell carcinoma lung cancer (NSCLC) with vascular stenting and iodine-125 implantation.
Feasibility and efficacy of sequentially performed endovascular stenting and Iodine-125 brachytherapy for malignant superior vena cava syndrome (SVCS) were evaluated. Thirty-four patients with malignant SVCS caused by NSCLC underwent sequential treatment of endovascular stenting and Iodine-125 brachytherapy. SVCS was diagnosed in all patients by CT images or vena-cavography. Pathology diagnosis was acquired by image guided biopsy. Endovascular stent placement was performed as first-line treatment for symptom relief. CT-guided Iodine-125 seed implantation performed 24hr after stenting. Clinical end points were resolution of symptoms and local efficacy of primary malignancy regression. Symptom relief rate was >90% after 24hr and 97% after 3 months. No migration of seeds or restenosis occurred in any patient. The local efficacy (defined as either partial or complete response) was 53%, 79%, 88% and 74% after 1, 3, 6 and 12 months, respectively. Mean SVCS-free survival time was 305 days (range 120-960 days). Two patients were still alive at the time of this writing, Thirty-one died from progression and one died from acute heart disease. Sequentially performed endovascular stenting and Iodine-125 brachytherapy provides a safe and effective alternative for malignant SVCS caused by NSCLC.
Xiao
Lianxiang
L
Shandong Medical Imaging Research Institute, Shandong University, Jinan 250012 Shandong, P.R China.
Li
Zhenjia
Z
Wu
Lebin
L
Sun
Zengtao
Z
Yu
Xianghong
X
D000368:Aged; D001918:Brachytherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000401:mortality; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000401:mortality / Q000628:therapy*; D014057:Tomography, X-Ray Computed
D007457:Iodine Radioisotopes