Pharmacologic Therapy

Cytotoxic chemotherapy is the treatment of choice for chemotherapy-sensitive tumors such as SCLC and lymphoma. As indicated above, chemotherapy may also be combined with radiotherapy, especially in patients with lymphoma who have bulky medi-astinal lymphadenopathy.

Corticosteroids play a key role in the management of SVCS, particularly in cases of lymphoma since these tumors inherently respond to corticosteroid therapy. They are also helpful in the setting of respiratory compromise. Corticosteroids benefit patients who are receiving radiation therapy by reduction of local radiation-induced inflammation and patients with increased ICP. Dexamethasone 4 mg IV or by mouth every 6 hours is a frequently used regimen. The dosage should be tapered upon completion of radiation therapy or resolution of symptoms.

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