Cavaliere Robert, Schiff David
Ohio State University, Department of Neurology, Room 463 Means Hall, 1654 Upham Drive, Columbus, OH 43210, USA.
Curr Neurol Neurosci Rep. 2006 May;6(3):218-26. doi: 10.1007/s11910-006-0009-8.
Neurologic dysfunction is a well-recognized adverse effect of cancer therapeutics. The most common manifestations include peripheral neuropathy and encephalopathy. Often, symptoms resolve or improve upon removal of the offending agent; therefore, it is essential that clinicians recognize the symptoms and signs of injury. Occasionally, symptoms persist or develop after discontinuation of medication and may culminate in disability and diminished quality of life. As our understanding of neurotoxicity improves, medications with less potential for injury may be developed. In addition, potential antidotes to prevent or reverse injury may emerge. This review focuses on the clinical features, mechanisms, and possible therapeutics of the neurotoxicity of chemotherapy. In particular, oxaliplatin, thalidomide, methotrexate, ifosfamide, cytarabine, amifostine, acetyl-L-carnitine, methylene blue, cytokines, and neurotrophins are discussed.
神经功能障碍是癌症治疗药物一种广为人知的不良反应。最常见的表现包括周围神经病变和脑病。通常,去除致病药物后症状会缓解或改善;因此,临床医生识别损伤的症状和体征至关重要。偶尔,停药后症状仍会持续或出现,并可能最终导致残疾和生活质量下降。随着我们对神经毒性的认识不断提高,可能会研发出损伤可能性较小的药物。此外,可能会出现预防或逆转损伤的潜在解毒剂。本综述重点关注化疗神经毒性的临床特征、机制和可能的治疗方法。特别讨论了奥沙利铂、沙利度胺、甲氨蝶呤、异环磷酰胺、阿糖胞苷、氨磷汀、乙酰-L-肉碱、亚甲蓝、细胞因子和神经营养因子。