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[化疗引起的神经病变]

[Chemotherapy-induced neuropathy].

作者信息

Boehmerle W, Huehnchen P, Endres M

机构信息

Klinik und Hochschulambulanz für Neurologie mit Lehrstuhl für Experimentelle Neurologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland,

出版信息

Nervenarzt. 2015 Feb;86(2):156-60. doi: 10.1007/s00115-014-4126-3.

Abstract

BACKGROUND

Neurological sequelae of cytostatic chemotherapy are a growing medical problem as the number of patients suffering from malignant diseases is steadily increasing.

OBJECTIVES

Chemotherapy-induced neuropathies (CIN) are among the most common side effects of many cytostatic drugs. Awareness of symptoms, diagnosis and treatment of these conditions are therefore highly relevant.

METHODS

A review of the primary and secondary literature was carried out.

RESULTS

This article reviews the literature on neuropathies induced by frequently used cytostatic drugs and discusses diagnostic, preventive and therapeutic strategies. Specifically, this review focuses on antibody-drug conjugates, platinum-based antineoplastic drugs, proteasome inhibitors, taxanes and vinca alkaloids. The lack of well-established preventive and therapeutic strategies complicates the management of CINs. The most successful approaches to CIN prevention are modifications of the treatment regime including single and cumulative doses, frequency and mode of infusion. Current evidence favors duloxetine as a symptomatic treatment of platinum-induced neuropathies.

CONCLUSION

The CINs are an unsolved medical problem. Knowledge of symptoms as well as preventive, diagnostic and therapeutic strategies is important when patients present in clinical practice with neurological symptoms following chemotherapy.

摘要

背景

随着恶性疾病患者数量稳步增加,细胞毒性化疗的神经后遗症成为一个日益严重的医学问题。

目的

化疗引起的神经病变(CIN)是许多细胞毒性药物最常见的副作用之一。因此,了解这些病症的症状、诊断和治疗至关重要。

方法

对一级和二级文献进行了综述。

结果

本文综述了关于常用细胞毒性药物引起的神经病变文献,并讨论了诊断、预防和治疗策略。具体而言,本综述重点关注抗体药物偶联物、铂类抗肿瘤药物、蛋白酶体抑制剂、紫杉烷类和长春花生物碱。缺乏成熟的预防和治疗策略使CIN的管理复杂化。预防CIN最成功的方法是调整治疗方案,包括单次和累积剂量、给药频率和输注方式。目前的证据支持度洛西汀作为铂类诱导神经病变的对症治疗药物。

结论

CIN是一个尚未解决的医学问题。当患者在化疗后出现神经症状就诊时,了解症状以及预防、诊断和治疗策略非常重要。

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