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Response of superior vena cava syndrome to radiation therapy

The treatment of a superior vena caval obstruction associated with a mediastinal mass is a true radiotherapeutic emergency. The heralding signs and symptoms and the morbidity of the syndrome justify beginning therapy before a pathologic diagnosis is established. In a series of 19 patients with superior vena cava syndrome, there was an excellent response to an initial high‐dose course of irradiation, consisting of 400 rads midplane for 3 days, then reduced to conventional daily fractionation. It is concluded that rapid high‐dose irradiation in the treatment of a superior vena cava syndrome is safe and effective.