To the Editor: In the August 16 issue of the Journal, Drs. Greco and Oldham proposed chemotherapy as the primary treatment for superior vena cava obstruction and bronchial obstruction due to small-cell carcinoma of the lung. They suggested that radiotherapy be used only if chemotherapy fails. I disagree with the authors. The literature is full of evidence that superior vena cava obstruction because of small-cell carcinoma or other types of lung carcinoma is one of the few true emergencies for which radiation is the treatment of choice.1 2 3,5 6 7 8 9 Rapid relief of signs and symptoms can be achieved with radiation therapy.
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