Lebrun C, Frenay M
Service de neurologie, CHU de Nice, 30, avenue de la Voie-Romaine, Nice cedex, France.
Rev Med Interne. 2010 Apr;31(4):295-304. doi: 10.1016/j.revmed.2009.12.005. Epub 2010 Feb 18.
Damage to the nervous system is a common side effect of antineoplastic therapy. The improvements in treating systemic malignancies have been accompanied by the reports of neurological toxicity that has important impact on quality of life and may even limit the use of the treatment. Neurotoxicity can be induced by synergistic or additive effects of cytotoxic drugs and nervous system exposure is related to routes and doses of administered drugs. Neurological toxicity may be a dose-limiting factor that prevents the more aggressive use of cytotoxic drugs. With the increasing use of multiple modality therapy, dose-intensive therapy and experimental therapy, the incidence of neurological toxicity is still rising. Early diagnosis is essential. Indeed, when neurological complications are diagnosed with delay, they are rarely reversible. Neuroprotective agents are still evaluated. The neurologic complications of the more commonly used chemotherapeutic agents, hormones and targeted molecular agents are discussed.
神经系统损伤是抗肿瘤治疗常见的副作用。在治疗全身性恶性肿瘤方面取得进展的同时,也有关于神经毒性的报道,这种毒性对生活质量有重要影响,甚至可能限制治疗的应用。神经毒性可由细胞毒性药物的协同或累加效应诱发,而神经系统暴露与给药途径和剂量有关。神经毒性可能是一个剂量限制因素,阻碍了细胞毒性药物更积极的使用。随着多模式治疗、剂量密集型治疗和实验性治疗的使用增加,神经毒性的发生率仍在上升。早期诊断至关重要。事实上,如果神经并发症诊断延迟,很少能逆转。神经保护剂仍在评估中。本文讨论了更常用的化疗药物、激素和靶向分子药物的神经并发症。