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After multidisciplinary assessment, inpatient hypofractionated external beam radiotherapy was planned, but treatment positioning needs required transfer for custom immobilization. Symptoms and oxygen requirements improved, enabling outpatient completion of remaining fractions and chemotherapy, highlighting hypofractionation and institutional adaptability during acute oncologic 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external beam radiotherapy led to marked improvement in symptoms and oxygen requirements, allowing transition to outpatient care for remaining fractions and chemotherapy.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},447968,1790764105,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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available at ScienceDirect  \nTechnical Innovations & Patient Support in Radiation Oncology  \njournal [homepage:](homepage: www.sciencedirect.com/journal/technical-innovations-and)[ www.sciencedirect.com/journal/technical-innovations-and](homepage: www.sciencedirect.com/journal/technical-innovations-and)patient-support-in-radiation-oncology  \n| Case reports and case series\u003Cbr>Urgent radiotherapy for superior vena cava syndrome in metastatic non-small cell lung cancer: a case report |  |  | |\n| --- | --- | --- | --- |\n| Arpeet Patel b , Nilanjan Haldara , Ida Micailyc , Michael Greenberg a, Evan Nardonec , John A. Lippert d , Christopher Fundakowski e, Adam C. Mueller a,f,* \u003Cbr>a Department of Radiation Oncology, Sidney Kimmel Medical College and Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA b Drexel University College of Medicine, Philadelphia, PA, USA\u003Cbr>c Department of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA d Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA\u003Cbr>e Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, USA\u003Cbr>f Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA |  |  |  |\n| A R T I C L E I N F O |  | A B S T R A C T |  |\n| Keywords:\u003Cbr>Superior vena cava syndrome Non-small cell lung cancer Hypofractionated regimen Oncologic emergency |  | 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. |  |\n\nIntroduction  \nSuperior vena cava syndrome (SVCS) arises from the obstruction of venous return from the head, neck, and upper extremities. Most cases are associated with thoracic malignancies, including non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), and lymphoma [1]. Compression or invasion of the SVC by mediastinal masses impairs venous drainage, resulting in symptoms including facial and upper extremity swelling, dyspnea, cough, and in advanced cases, cerebral edema or stridor [2]. The severity of these symptoms is dependent on the acuity of onset and the availability of collateral venous drainage. Biopsy and histological confirmation of malignancy remain critical in diagnosis, after which emergent treatment can be performed to manage airway compromise or hemodynamic instability [3].  \nTreatment for SVC syndrome secondary to malignancy is typically  \npalliative due to poor prognosis and depends on the histology of the obstructing tumor [4]. Patients with SCLC respond well to chemotherapy due to the tumor being chemosensitive. However, for NS","cbCaiu4nzdgAqJ95","https://ap.wps.com/l/cbCaiu4nzdgAqJ95","pdf",2519261,"English","# Introduction\n## Causes and clinical features of SVCS\n## Diagnostic steps and need for emergent therapy\n## Treatment approach by cancer histology\n## Role of external beam and hypofractionated regimens","[{\"question\":\"What causes superior vena cava syndrome in this case?\",\"answer\":\"Superior vena cava syndrome resulted from compression of the SVC by a large mediastinal mass, identified as metastatic lung adenocarcinoma.\"},{\"question\":\"Why was the patient transferred to another center?\",\"answer\":\"The patient could not tolerate lying supine for radiation due to dyspnea, so he was transferred to an academic center with a custom immobilization setup.\"},{\"question\":\"How did hypofractionated radiotherapy affect the patient’s outcome?\",\"answer\":\"The hypofractionated external beam radiotherapy led to marked improvement in symptoms and oxygen requirements, allowing transition to outpatient care for remaining fractions and chemotherapy.\"}]","Urgent radiotherapy for superior vena cava syndrome in metastatic non-small cell lung cancer - a case report | PDF",1790724435,13]