Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Via Cadore 48, Monza, Italy.
Nat Rev Neurol. 2010 Dec;6(12):657-66. doi: 10.1038/nrneurol.2010.160. Epub 2010 Nov 9.
Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common, potentially severe and dose-limiting adverse effect of cancer treatment; however, the effects of CIPN on the daily life of individuals are not completely understood. CIPN can be induced by several types of drugs that are widely used in the treatment of solid and hematological malignancies. Our knowledge of the mechanisms underlying CIPN is incomplete, but structural properties of the various neurotoxic compounds might contribute to variations in the pathogenetic mechanisms of damage, in addition to the type of neurotoxicity, severity of the clinical condition, and incidence of CIPN. No drugs capable of preventing the occurrence of CIPN or ameliorating its long-term course are available, and chemotherapy schedule modification is often required to limit its severity, which could potentially prevent patients from receiving the most effective treatment for cancer. Moreover, symptomatic therapy is often largely ineffective in reducing CIPN symptoms. In this Review, the mechanistic and clinical aspects of this unpredictable condition are considered, along with the controversial aspects of CIPN, including the onset mechanisms associated with the different drug types, assessment of the patient's condition, and the current status of neuroprotection and treatment options.
化疗引起的周围神经毒性（CIPN）是癌症治疗中一种常见的、潜在严重且剂量限制的不良反应；然而，CIPN 对个体日常生活的影响尚未完全被理解。CIPN 可由几种广泛用于治疗实体瘤和血液恶性肿瘤的药物引起。我们对 CIPN 发病机制的了解并不完全，但各种神经毒性化合物的结构特性除了神经毒性类型、临床状况严重程度和 CIPN 的发生率之外，可能有助于损伤发病机制的变化。目前尚无能够预防 CIPN 发生或改善其长期病程的药物，因此通常需要修改化疗方案以限制其严重程度，这可能会导致患者无法接受最有效的癌症治疗。此外，对症治疗在很大程度上对于减轻 CIPN 症状效果不佳。在这篇综述中，考虑了这种不可预测情况的机制和临床方面，以及 CIPN 的争议方面，包括与不同药物类型相关的发病机制、患者病情评估以及神经保护和治疗选择的现状。
