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Urgent radiotherapy for superior vena cava syndrome in metastatic non-small cell lung cancer: a case report
Journal article   Open access   Peer reviewed

Urgent radiotherapy for superior vena cava syndrome in metastatic non-small cell lung cancer: a case report

Arpeet Patel, Nilanjan Haldar, Ida Micaily, Michael Greenberg, Evan Nardone, John A. Lippert, Christopher Fundakowski and Adam C. Mueller
Technical innovations & patient support in radiation oncology, v 37, 100365
01 Mar 2026
PMID: 41510316
url
https://doi.org/10.1016/j.tipsro.2025.100365View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Radiology, Nuclear Medicine & Medical Imaging Science & Technology Oncology
Superior vena cava (SVC) syndrome is a life-threatening complication of thoracic malignancies, requiring rapid management in the setting of airway compromise or hemodynamic instability. We present a 59-year-old male with metastatic non-small cell lung cancer (NSCLC) who developed superior vena cava syndrome (SVCS) due to compression from a large mediastinal mass identified as metastatic lung adenocarcinoma. His declining respiratory status progressed rapidly, necessitating intensive care. After extensive multidisciplinary collaboration, the patient was determined fit for inpatient radiation therapy and 10 fractions of 300 cGy external beam radiotherapy to the obstructing lesion was planned. However, the patient was unable to lay supine for radiation treatment due to dyspnea, so he was transferred to an academic center, where custom immobilization setup was available to accommodate the patient's inability to tolerate a standardized supine position utilized by most outpatient radiation centers. The patient's symptoms and oxygen requirement then improved markedly, enabling transition to outpatient care for the remaining two radiotherapy (RT) fractions and chemotherapy. This case highlights the value of hypofractionated radiotherapy and institutional adaptability in managing acute oncologic emergencies such as SVC syndrome.

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Collaboration types
Domestic collaboration
Web of Science research areas
Oncology
Radiology, Nuclear Medicine & Medical Imaging
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