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, may result in additional benefit ? (Sisson et al. 1999) 2022/6/23 28 Alternative of Current Therapy ? Surgery ? Radiopharmaceuticals ? Combined Chemotherapy ? Arterial Embolization 2022/6/23 29 ? Only sparse data on chemotherapeutic regimens are available, most of them in reports of few cases ? The most wellestablished regimen is CVD (Averbuch et al. 1988) ? CTX 750mg/m2 d1, VCR , Dacarbazine 600mg/m2 d1,2 ? Cycle 21 days 2022/6/23 30 ? The CVD regimen was based on the treatment for advanced neuroblastoma. ? This regimen has been reported to produce good responses in malignant pheochromocytoma, but the median duration of remission is 21 months ? Complete longterm disease remissions with chemotherapy have not been reported. 2022/6/23 31 Alternative of Current Therapy ? Surgery ? Radiopharmaceuticals ? Combined Chemotherapy ? Transcatheter Arterial Embolization 2022/6/23 32 ? TAE has been successfully performed in the treatment of malignant PCC with liver metastases ? The therapeutic effects of TAE have been demonstrated to be enhanced by the bination therapy with anticancer chemotherapy 2022/6/23 33 ? Mitomycin C has been successfully used in TAE for liver metastasis in several cases of malignant PCC. 2022/6/23 34 2022/6/23 35 Malignant pheochromocytoma: past, present and future Past Present Future Adrenergic blockers, αmethylparatyrosine amp。 use of other drugs for symptomatic relief Surgical debulking。 131IMIBG radiotherapy。 Chemotherapy。 Chemoembolization Molecular targeting, cancer vaccines, gene therapy