Document Type

Report

Publication Date

12-5-2025

Comments

This article is the author’s final published version in Technical Innovations and Patient Support in Radiation Oncology, Volume 37, 2026, Article number 100365.

The published version is available at https://doi.org/10.1016/j.tipsro.2025.100365. Copyright © 2025 The Author(s).

 

Abstract

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.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

41510316

Language

English

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