Hematology and Oncology Program, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA.
Semin Pediatr Neurol. 2012 Mar;19(1):9-17. doi: 10.1016/j.spen.2012.02.011.
Chemotherapy forms the backbone of treatment for many types of pediatric cancers, but a main side effect of treatment is chemotherapy-induced peripheral neuropathy (CIPN). Damage to the peripheral nervous system by chemotherapeutic agents can occur at the axon, cell body, or myelin level, and the mechanism of damage differs based on the specific chemotherapeutic agent used. This review provides background on the current knowledge of pathophysiology, assessment, and intervention for CIPN, focusing specifically on issues relevant in pediatric cancers patients. Although specific, standardized measures of CIPN are available for adults, such measures are limited for use in the pediatric populations. Likewise, clinical trials for prevention and treatment of this neuropathy and related symptoms are rare in pediatrics, but some information can be gained from the basic and adult literature.
化疗是许多类型儿科癌症治疗的基础,但治疗的一个主要副作用是化疗引起的周围神经病变(CIPN)。化疗药物对周围神经系统的损伤可发生在轴突、细胞体或髓鞘水平,损伤机制因所用的特定化疗药物而异。这篇综述提供了关于 CIPN 的病理生理学、评估和干预的当前知识背景,特别关注与儿科癌症患者相关的问题。尽管成人有特定的、标准化的 CIPN 测量方法,但这些方法在儿科人群中使用有限。同样,儿科预防和治疗这种神经病变及相关症状的临床试验很少,但可以从基础和成人文献中获得一些信息。