Clinical observation on efficacy of body-γ-knife combined with chemotherapy in the alleviative treatment of supeerior vena cava syndrome

WU Qingmu; ZHANG Jiangling; ZHEN Weibin; GAO Qinglong

doi:10.3969/j.issn.1009-0460.2017.05.014

Abstract：Objective To investigate the efficacy of the alleviative treatment of superior vena cava syndrome(SVCS) combined body-γ-knife with chemotherapy.Methods Fifty-five cases of SVCS were treated with γ-knife combined with 1 cycle chemotherapy in the.After the γ-knife treatment,the patients were received 4 to 6 cycles of chemotherapy;the 50% isodose curve was used as the prescerption isodose curve to wrap PTV,and the 60% odose curve wrapped more than 90% GTV;according to the pathological type,the total dose was 45-54 Gy for 10-12 fractions.The symptom relief rate,short-term efficacy and long-term efficacy were observed.Results All of the 55 patients were accomplished treatment according to the plan, all the symptoms of SVCS were relieved during the treatment of γ-knife and median treatment was 6 times.There was no one patient who had not been relieved.The complete remission was achieved in 28 cases (50.9%) within two weeks,the total effective rate of two months was 98.2%(54/55).There was no one patient with PD.All patients were followed up for 1-31 months.The 1-year survival rate was 72.7% (40/55), 2-year survival rate was 43.6% (24/55);4 cases of grade 0-1 grade acute radiation pneumonitis (7.2%),3 cases of grade 0-1 grade acute radiation esophagitis (5.4%),9 cases of grade 0-2 bone marrow suppression (16.3%),12 cases of grade 0-2 gastrointestinal reaction (21.8%),4 cases of alopecia (7.2%),and did not appear 3-4 grade adverse reactions.Conclusion γ-knife combined with chemotherapy in the treatment of SVCS has the characteristics of fast response,high efficiency,low recurrence rate,good tolerability and fewer side effects,therefore combined body-γ-knife with chemotherapy as therapeutic strategy is a good method to treat SVCS.