Department of Neurology and MGH Cancer Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
Division of Hematology and Oncology, Department of Internal Medicine, East Carolina University, 600 Moye Boulevard, Greenville, NC 27858-4353, USA.
Hematol Oncol Clin North Am. 2022 Feb;36(1):217-236. doi: 10.1016/j.hoc.2021.08.005. Epub 2021 Oct 2.
Cancer treatment related injury to the central nervous system (CNS) is well-recognized in the setting of brain-directed radiation therapies and conventional and novel systemic anticancer therapies. Late-delayed treatment-induced CNS complications frequently result in permanent neurologic disability. Therapeutic options are supportive with limited clinical benefit, whereby alteration or discontinuation of the overall antineoplastic treatment plan is frequently necessary to prevent further neurologic injury. Better identification of patients at high risk for developing late CNS toxicities, neuroprotective strategies with modification of existing antineoplastic treatment regimens, and research efforts directed at earlier recognition and improved treatment of central neurologic complications are paramount.
癌症治疗相关的中枢神经系统（CNS）损伤在脑定向放射治疗以及传统和新型全身抗癌治疗中是众所周知的。迟发性治疗相关的 CNS 并发症常导致永久性神经功能障碍。治疗选择是支持性的，临床获益有限，因此，为了防止进一步的神经损伤，通常需要改变或停止整体抗肿瘤治疗计划。更好地识别发生晚期 CNS 毒性的高风险患者，通过改变现有的抗肿瘤治疗方案来进行神经保护策略，以及针对中枢神经系统并发症的早期识别和改善治疗的研究工作是至关重要的。
Zotero 插件