Pheochromocytoma medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Pheochromocytoma}} | {{Pheochromocytoma}} | ||
{{CMG}} {{AE}} {{AAM}} | {{CMG}}; {{AE}} {{AAM}} | ||
==Overview== | ==Overview== | ||
Treatment with [[alpha blockers]] (example: [[phenoxybenzamine]]) followed by [[beta blockers]] (example: [[atenolol]]) is required before surgery. Adjunctive [[chemotherapy]] and [[radiation]] are used in metastatic disease. | Treatment with [[alpha blockers]] (example: [[phenoxybenzamine]]) followed by [[beta blockers]] (example: [[atenolol]]) is required before surgery. Adjunctive [[chemotherapy]] and [[radiation]] are used in metastatic disease. | ||
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==Medical Therapy== | ==Medical Therapy== | ||
Any surgical option requires prior treatment with both the non-selective [[alpha blocker|alpha adrenoceptor blocker]] ([[phenoxybenzamine]]) to counteract [[hypertension]] and the beta-1 adrenoceptor antagonist [[atenolol]] to reduce [[cardiac output]]. Given before surgery, these can also block the effect of a sudden release of adrenaline during tumour resection, which would otherwise endanger the anaesthetised patient. | Any surgical option requires prior treatment with both the non-selective [[alpha blocker|alpha adrenoceptor blocker]] ([[phenoxybenzamine]]) to counteract [[hypertension]] and the beta-1 adrenoceptor antagonist [[atenolol]] to reduce [[cardiac output]]. Given before surgery, these can also block the effect of a sudden release of adrenaline during tumour resection, which would otherwise endanger the anaesthetised patient. | ||
===Chemotherapy=== | ===Chemotherapy=== | ||
Metastatic pheochromocytoma is treated with Averbuc protocol which is a combination of [[cyclophosphamide]], [[vincristine]], and [[dacarbazine]].<ref name="cancergov"> National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_179_toc</ref> | Metastatic pheochromocytoma is treated with Averbuc protocol which is a combination of [[cyclophosphamide]], [[vincristine]], and [[dacarbazine]].<ref name="cancergov"> National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_179_toc</ref> | ||
===Radiation=== | ===Radiation=== | ||
<sup>131</sup>I-MIBG radiation therapy has been used for the treatment of MIBG-avid metastases.<ref name="cancergov"> National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_179_toc</ref> | <sup>131</sup>I-MIBG radiation therapy has been used for the treatment of MIBG-avid metastases.<ref name="cancergov"> National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_179_toc</ref> | ||
===Contraindicated medications=== | ===Contraindicated medications=== | ||
{{MedCondContrAbs | {{MedCondContrAbs | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Endocrinology]] | |||
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{{WH}} | {{WH}} | ||
Revision as of 20:14, 25 July 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]
Overview
Treatment with alpha blockers (example: phenoxybenzamine) followed by beta blockers (example: atenolol) is required before surgery. Adjunctive chemotherapy and radiation are used in metastatic disease.
Medical Therapy
Any surgical option requires prior treatment with both the non-selective alpha adrenoceptor blocker (phenoxybenzamine) to counteract hypertension and the beta-1 adrenoceptor antagonist atenolol to reduce cardiac output. Given before surgery, these can also block the effect of a sudden release of adrenaline during tumour resection, which would otherwise endanger the anaesthetised patient.
Chemotherapy
Metastatic pheochromocytoma is treated with Averbuc protocol which is a combination of cyclophosphamide, vincristine, and dacarbazine.[1]
Radiation
131I-MIBG radiation therapy has been used for the treatment of MIBG-avid metastases.[1]
Contraindicated medications
Pheochromocytoma is considered an absolute contraindication to the use of the following medications:
References
- ↑ 1.0 1.1 National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq#link/_179_toc