关键词: Lung cancer Oncologic emergencies Oncologic emergency SVCS Superior vena cava syndrome Thoracic cancer

Mesh : Humans Superior Vena Cava Syndrome / etiology therapy Vena Cava, Superior Lung Neoplasms / complications Stents / adverse effects Thrombosis

来  源:   DOI:10.1016/j.jtho.2023.04.019

Abstract:
Malignant superior vena cava syndrome (SVCS) is a clinical problem that results from the obstruction of blood flow in the superior vena cava by an underlying malignancy. This may occur due to external compression, neoplastic invasion of the vessel wall, or internal obstruction with bland or tumor thrombus. Although symptoms are typically mild, SVCS can cause neurologic, hemodynamic, and respiratory compromise. Classic management options include supportive measures, chemotherapy, radiation therapy, surgery, and endovascular stenting. New targeted therapeutics and techniques have also recently been developed, which may have a role in management. Nevertheless, few evidence-based guidelines exist to guide treatment of malignant SVCS, and these recommendations are typically restricted to individual disease sites. Furthermore, there are no recent systematic literature reviews that address this question. Here, we present a theoretical case to frame this clinical problem and synthesize updated evidence published in the past decade relating to the management of malignant SVCS through a comprehensive literature review.
摘要:
恶性上腔静脉综合征(SVCS)是由于潜在的恶性肿瘤阻塞了通过上腔静脉的血流而引起的临床问题。这可能是由于外部压缩,血管壁肿瘤侵袭,或内部梗阻伴温和或肿瘤血栓。虽然症状通常很轻微,SVCS可以引起神经系统,血液动力学,和呼吸损害。经典的管理选项包括支持措施,化疗,放射治疗,手术,血管内支架置入术.最近还开发了可能在管理中发挥作用的新的靶向疗法和技术。然而,很少有循证指南来指导恶性SVCS的治疗,这些建议通常仅限于个别疾病部位。此外,最近没有系统的文献综述来解决这个问题。这里,我们提出了一个理论案例来构建这个临床问题,并通过全面的文献综述,综合过去十年中发表的有关恶性SVCS管理的最新证据。
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