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化疗引起的周围神经病变的诊断、管理与评估

Diagnosis, management, and evaluation of chemotherapy-induced peripheral neuropathy.

作者信息

Hausheer Frederick H, Schilsky Richard L, Bain Stacey, Berghorn Elmer J, Lieberman Frank

机构信息

BioNumerik Pharmaceuticals, Inc, San Antonio, TX 78229, USA.

出版信息

Semin Oncol. 2006 Feb;33(1):15-49. doi: 10.1053/j.seminoncol.2005.12.010.

Abstract

Peripheral neuropathy induced by cancer chemotherapy represents a large unmet need for patients due to the absence of treatment that can prevent or mitigate this common clinical problem. Chemotherapy-induced peripheral neuropathy (CIPN) diagnosis and management is further compounded by the lack of reliable and standardized means to diagnose and monitor patients who are at risk for, or who are symptomatic from, this complication of treatment. The pathogenesis and pathophysiology of CIPN are not fully elucidated, but there is increasing evidence of damage or interference with tubulin function. The diagnosis of CIPN may present a diagnostic dilemma due to the large number of potential toxic etiologies and conditions, which may mimic some of the clinical features; the diagnosis must be approached with care in such patients. The incidence and severity of CIPN is commonly under-reported by physicians as compared with patients. The development of new and reliable methods for the assessment of CIPN as well as safe and effective treatments to prevent this complication of treatment would represent important medical advancements for cancer patients.

摘要

由于缺乏能够预防或减轻这一常见临床问题的治疗方法,癌症化疗引起的周围神经病变给患者带来了巨大的未满足需求。化疗引起的周围神经病变(CIPN)的诊断和管理因缺乏可靠和标准化的手段来诊断和监测有这种治疗并发症风险或出现症状的患者而变得更加复杂。CIPN的发病机制和病理生理学尚未完全阐明,但越来越多的证据表明微管蛋白功能受到损害或干扰。由于存在大量可能的毒性病因和病症会模仿一些临床特征,CIPN的诊断可能会带来诊断难题;对此类患者进行诊断时必须谨慎。与患者相比,医生通常对CIPN的发病率和严重程度报告不足。开发用于评估CIPN的新的可靠方法以及预防这种治疗并发症的安全有效治疗方法将是癌症患者的重要医学进展。

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