Superior vena cava syndrome in non-lung primary tumours treated with palliative intent - Research paper

Sep 22, 2026

Background: This retrospective study evaluates the impact of systemic treatment on overall survival (OS) in patients with superior vena cava (SVC) syndrome caused by neoplasms other than lung and haematological cancers. Materials and methods: Patient records were reviewed, and Cox proportional hazards regression assessed associations with time to death. Results: Twenty-four patients were included; systemic treatment showed exploratory survival improvement, while loop diuretics correlated with higher mortality, and steroids showed no survival benefit. Conclusions: Findings suggest potential benefit of systemic therapy but require validation due to limited sample size and model instability.

LanguageEnglish

CategoryHealthcare

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Abstract

Introduction

Materials and methods

Patients

Procedures

REPORTS OF PRACTICAL ONCOLOGY AND RADIOTHERAPY © 2026 Greater Poland Cancer Centre. Published by Via Medica. All rights reserved. e-ISSN 2083–4640 ISSN 1507–1367 ISSN: 1507–1367 RESEARCH PAPER Reports of Practical Oncology and Radiotherapy 2026, Volume 31, Number 4, pages: 520–529 DOI: 10.5603/rpor.112680 Submitted: 3.09.2025 Accepted: 15.05.2026 Superior vena cava syndrome in non-lung primary tumours treated with palliative intent Aniwat Berpan1, Kyrhatii Trikhirhisthit2, Kullathorn Thephamongkhol3, Wasu Tanasoontrarat4 1Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand 2Division of Radiation Oncology, Department of Radiology, Sawanpracharak Hospital, Nakhonsawan, Thailand 3Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 4Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand ABSTRACT Background: This study aimed to evaluate the effects of systemic treatment on the overall survival (OS) of patients with superior vena cava (SVC) syndrome caused by neoplasms other than lung and haematological cancers. Materials and methods: Patient data were collected retrospectively. Cox proportional hazards regression was used to analyse the associations between variables and time to death. Results: Twenty-four patients were identified. The median follow-up time was 36 months. The median OS of patients receiving upfront systemic treatment and radiotherapy were 252 and 150 days (p = 0.298), and the 1-year OS rates were 20% and 22.7%, respectively. Patients treated with and without steroids had 1-year OS rates of 30.8% and 10.1% and median OS of 154 and 224 days, respectively (p = 0.426). The median OS of patients treated with and without loop diuretics was 114 and 252 days (p = 0.004), and the 1-year OS rates were 0% and 33.6%, respectively. In multivariable analysis, significant independent factors included upfront systemic therapy [hazard ratio (HR) = 0.022; 95% confidence interval (CI): 0.001–0.413], loop diuretics (HR = 12.364; 95% CI: 2.093–73.032), male sex (HR = 9.746; 95% CI: 1.478–64.276), visceral metastases (HR = 96.265; 95% CI: 5.437–1704.39), and previous systemic treatment for nonmetastatic disease (HR = 0.072; 95% CI: 0 .005–0.955) . Conclusions: In multivariable analysis, systemic treatment was associated with improved survival. However, this finding remains exploratory because of the small sample size and model instability. Loop diuretics were associated with increased mortality, and steroids showed no benefit in improving survival. Keywords: loop diuretics; radiotherapy; systemic treatment Rep Pract Oncol Radiother 2026;31(4):520–529 Introduction In 1983, Spiro et al. [1] compared the effects of chemotherapy with and without radiotherapy in superior vena cava (SVC) syndrome due to small-cell lung cancer and observed no difference in overall survival (OS) . In another study, 28 patients with SVC syndrome were randomised to receive either nitrogen mustard followed by radiation or radiation alone. In this study, most patients had lung cancer; only 2 patients had lymphoma and 1 patient had malignant thymoma. The study showed no advantage of nitrogen mustard prior to radiotherapy [2] . In patients with non-small-cell lung Address for correspondence: Aniwat Berpan, Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Road, Dusit, Bangkok 10300, Thailand, e-mail: berpanmaster@hotmail.com This article is available in open access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0), which permits users to download and share the article with others, provided that they credit the authors and the publisher, do not alter t

FAQs

What was the study’s primary aim regarding superior vena cava (SVC) syndrome?

To evaluate how systemic treatment affects overall survival in SVC syndrome caused by non-lung primary neoplasms and excluding haematological cancers.

How were patients selected for this retrospective analysis?

Patients treated between January 2012 and August 2022 with radiologically confirmed SVC obstruction and histologically or cytologically confirmed neoplasm receiving systemic therapy or radiotherapy as upfront treatment were included.

Which treatments were associated with survival outcomes in multivariable analysis?

Upfront systemic therapy was associated with improved survival, while loop diuretics were associated with increased mortality; steroids showed no survival benefit.

Sep 22, 2026

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