Visovsky Constance
Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA.
Cancer Invest. 2003 Jun;21(3):439-51. doi: 10.1081/cnv-120018236.
While cancer remains an important public health concern, novel and enhanced treatment modalities have increased the length of survival of individuals diagnosed with the disease. The treatment of most cancers requires the use of chemotherapeutic agents to affect cure, maintain control of the disease, or provide palliation of symptoms. Although the use of chemotherapeutic agents can serve to prolong life, such agents are associated with significant side effects. Increasing clinical evidence suggests treatment of cancer with neurotoxic agents results in some degree of peripheral neuropathy. Specific drug categories implicated in the development of peripheral neuropathy are the plant alkaloids, interferons, antimitotics, taxanes, and platinum-based compounds. Drug-induced peripheral neuropathy is sensory, dose-related and cumulative and is usually delayed, appearing weeks after initiation of therapy. The number of individuals at risk for the development of chemotherapy-induced neuropathy is expected to increase proportionately with clinical protocols utilizing higher or more frequent dosing. As advanced cancer treatments and clinical trials can result in extending the lives of individuals affected by cancer, long-term functional deficits resulting from life-saving treatments must now be addressed. As such, peripheral neuropathy has emerged as an important consequence of cancer therapy.
虽然癌症仍然是一个重要的公共卫生问题,但新型和改进的治疗方式延长了被诊断患有该疾病的个体的生存期。大多数癌症的治疗需要使用化疗药物来实现治愈、维持疾病控制或缓解症状。尽管使用化疗药物可以延长生命,但这些药物会带来显著的副作用。越来越多的临床证据表明,使用神经毒性药物治疗癌症会导致一定程度的周围神经病变。与周围神经病变发生相关的特定药物类别包括植物生物碱、干扰素、抗有丝分裂药物、紫杉烷类和铂类化合物。药物性周围神经病变是感觉性的、与剂量相关且具有累积性,通常会延迟出现,在治疗开始数周后显现。随着使用更高剂量或更频繁给药的临床方案的实施,有化疗诱导神经病变风险的个体数量预计将相应增加。由于晚期癌症治疗和临床试验能够延长癌症患者的生命,现在必须解决挽救生命的治疗所导致的长期功能缺陷问题。因此,周围神经病变已成为癌症治疗的一个重要后果。