Beijers A J M, Jongen J L M, Vreugdenhil G
Department of Internal Medicine, Maxima Medical Centre, Veldhoven, the Netherlands.
Neth J Med. 2012 Jan;70(1):18-25.
Chemotherapy-induced peripheral neuropathy (CIPN) is a common major dose-limiting side effect of many chemotherapeutic agents, including platinum compounds, taxanes, vinca alkaloids, thalidomide and newer agents such as bortezomib. The incidence and degree of neuropathy depends on the type of cytotoxic drug, the duration of administration, cumulative dose and pre-existing peripheral neuropathy. Because of increasing survival rates of patients treated with neurotoxic agents, CIPN is accompanied by a significant decrease in the patient's quality of life among cancer survivors. Therefore, several neuroprotective strategies, including calcium/magnesium infusion, amifostine, gluthatione, glutamine, acetyl-L-carnitine and erythropoietin as most promising, have been investigated to decrease the neurotoxicity without compromising anti-tumour efficacy. However, clinical evidence for the efficacy of these drugs is sparse. In this review we will give an outline of the neurotoxic effects of chemotherapeutic agents, their clinical manifestations and potential neuroprotective strategies.
化疗引起的周围神经病变（CIPN）是许多化疗药物常见的主要剂量限制性副作用，这些药物包括铂类化合物、紫杉烷类、长春花生物碱、沙利度胺以及新型药物如硼替佐米。神经病变的发生率和程度取决于细胞毒性药物的类型、给药持续时间、累积剂量以及既往存在的周围神经病变。由于接受神经毒性药物治疗的患者生存率不断提高，CIPN导致癌症幸存者的生活质量显著下降。因此，人们研究了多种神经保护策略，包括输注钙/镁、氨磷汀、谷胱甘肽、谷氨酰胺、乙酰左旋肉碱和促红细胞生成素等最具前景的策略，以在不影响抗肿瘤疗效的情况下降低神经毒性。然而，这些药物疗效的临床证据并不充分。在本综述中，我们将概述化疗药物的神经毒性作用、临床表现及潜在的神经保护策略。
