Department of Neurology, MGH Cancer Center, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Yawkey 9E, Boston, Massachusetts 02114, USA.
Adv Exp Med Biol. 2010;678:77-85. doi: 10.1007/978-1-4419-6306-2_11.
Chemotherapy is commonly associated with harmful effects to multiple organ systems, including the central nervous system (CNS). Neurotoxicity may manifest as both acute and delayed complications, which is particularly a concern for long-term survivors. Patients may experience a wide range of neurotoxic syndromes, ranging from neuro-vascular complications and focal neurological deficits to generalized neurological decline with cognitive impairment, cortical atrophy and white matter abnormalities. Along with the use of more aggressive and combined treatment modalities and prolonged survival of cancer patients, neurological complications have been observed with increasing frequency. The mechanisms by which cancer therapy, including chemotherapy and radiation, result in neurological complications, have been poorly understood. Recent studies have now started to unravel the cell-biological basis for commonly seen neurotoxic syndromes and have provided compelling explanations for delayed neurological complications, such as cognitive decline, progressive myelin disruption and brain atrophy.
化疗通常与多个器官系统的有害作用相关，包括中枢神经系统（CNS）。神经毒性可能表现为急性和迟发性并发症，这对长期幸存者尤其令人担忧。患者可能会经历广泛的神经毒性综合征，从神经血管并发症和局灶性神经功能缺损到伴有认知障碍、皮质萎缩和白质异常的全面性神经功能下降。随着更具侵袭性和联合治疗模式的应用以及癌症患者生存时间的延长，神经系统并发症的发生频率不断增加。人们对癌症治疗（包括化疗和放疗）导致神经系统并发症的机制知之甚少。最近的研究开始揭示常见神经毒性综合征的细胞生物学基础，并为迟发性神经系统并发症（如认知能力下降、进行性髓鞘破坏和脑萎缩）提供了令人信服的解释。
