Liu Yan-Wen, Liu Chun-Ting, Su Yu-Li, Tsai Ming-Yen
Altern Ther Health Med. 2020 Jul;26(4):43-49.
Chemotherapy-induced peripheral neuropathy (CIPN) is a common troublesome side effect and affects long-term activities of daily living. This neuropathic disorder is still difficult to treat with current clinical treatments. The aim of this study was to investigate and offer an updated perspective of complementary therapies for CIPN.
This review included current databases, including PubMed, Embase, the Cochrane Database, Google Scholar, and Ovid Medline, published up to May 2019 in the English language, to summarize the role of nutrient supplements in CIPN, based on evidence from both animal and clinical studies.
A total of 58 studies were included in this review. There were 19 preclinical studies that reported mechanisms of effects and 31 clinical studies corroborated preclinical findings, including 22 randomized controlled trials and 3085 patients with CIPN. Interventions included vitamin E, vitamin B complex, glutamine, acetyl-L-carnitine, alpha lipoic acid, glutathione, omega-3 fatty acids, and calcium/magnesium (Ca2+/Mg2+). The administration of various nutrients remains inconsistent, and limited evidence of effective ones for treating CIPN is available. However, glutamine and omega-3 fatty acids present potential as treatment options for CIPN. The evidence on vitamin E and vitamin B complex is inconclusive, and some forms of vitamin B, such as B6 or B12, await confirmation of their potential to offer protection from CIPN. Less robust evidence was found for nutrients such as acetyl-L-carnitine, α-Lipoic acid, glutathione, and Ca2+/Mg2+ for CIPN.
Nutritional therapists seem to recommend nutrient supplements as potential anti-inflammatory and neuroprotective agents for both the prevention and management of CIPN. An understanding of this evolving literature is useful in exploring these therapies with patients who are considering using them. However, their effects against CIPN are still controversial due to the undetermined neuropathic mechanisms of different antineoplastic agents and complex drug interactions. Further research on these agents is warranted.
化疗引起的周围神经病变（CIPN）是一种常见且棘手的副作用，会影响长期日常生活活动。这种神经病变目前的临床治疗仍难以治愈。本研究旨在调查并提供关于CIPN补充疗法的最新观点。
本综述纳入了截至2019年5月发表的英文数据库，包括PubMed、Embase、Cochrane数据库、谷歌学术和Ovid Medline，以基于动物和临床研究证据总结营养补充剂在CIPN中的作用。
本综述共纳入58项研究。有19项临床前研究报告了作用机制，31项临床研究证实了临床前研究结果，包括22项随机对照试验和3085例CIPN患者。干预措施包括维生素E、复合维生素B、谷氨酰胺、乙酰左旋肉碱、α硫辛酸、谷胱甘肽、ω-3脂肪酸以及钙/镁（Ca2+/Mg2+）。各种营养素的给药方式仍不一致，且治疗CIPN有效营养素的证据有限。然而，谷氨酰胺和ω-3脂肪酸有作为CIPN治疗选择的潜力。维生素E和复合维生素B的证据尚无定论，某些形式的维生素B，如B6或B12，其预防CIPN的潜力有待证实。对于乙酰左旋肉碱、α硫辛酸、谷胱甘肽和Ca2+/Mg2+等营养素治疗CIPN的证据不足。
营养治疗师似乎推荐营养补充剂作为预防和管理CIPN的潜在抗炎和神经保护剂。了解这一不断发展的文献对于与考虑使用这些疗法的患者探讨这些疗法很有用。然而，由于不同抗肿瘤药物的神经病变机制未明以及复杂的药物相互作用，它们对CIPN的疗效仍存在争议。有必要对这些药物进行进一步研究。
