Chung Kaitlin H, Park Susanna B, Streckmann Fiona, Wiskemann Joachim, Mohile Nimish, Kleckner Amber S, Colloca Luana, Dorsey Susan G, Kleckner Ian R
Department of Surgery, Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY 14642, USA.
Faculty of Medicine and Health, School of Medical Sciences, Brain and Mind Centre, The University of Sydney, Sydney, NSW 2006, Australia.
Cancers (Basel). 2022 Feb 26;14(5):1224. doi: 10.3390/cancers14051224.
Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of neurotoxic antineoplastic agents commonly used to treat cancer. Patients with CIPN experience debilitating signs and symptoms, such as combinations of tingling, numbness, pain, and cramping in the hands and feet that inhibit their daily function. Among the limited prevention and treatment options for CIPN, exercise has emerged as a promising new intervention that has been investigated in approximately two dozen clinical trials to date. As additional studies test and suggest the efficacy of exercise in treating CIPN, it is becoming more critical to develop mechanistic understanding of the effects of exercise in order to tailor it to best treat CIPN symptoms and identify who will benefit most. To address the current lack of clarity around the effect of exercise on CIPN, we reviewed the key potential mechanisms (e.g., neurophysiological and psychosocial factors), mediators (e.g., anti-inflammatory cytokines, self-efficacy, and social support), and moderators (e.g., age, sex, body mass index, physical fitness, exercise dose, exercise adherence, and timing of exercise) that may illuminate the relationship between exercise and CIPN improvement. Our review is based on the studies that tested the use of exercise for patients with CIPN, patients with other types of neuropathies, and healthy adults. The discussion presented herein may be used to (1) guide oncologists in predicting which symptoms are best targeted by specific exercise programs, (2) enable clinicians to tailor exercise prescriptions to patients based on specific characteristics, and (3) inform future research and biomarkers on the relationship between exercise and CIPN.
化疗引起的周围神经病变（CIPN）是常用于治疗癌症的神经毒性抗肿瘤药物的一种不良反应。患有CIPN的患者会出现使人衰弱的体征和症状，例如手脚出现刺痛、麻木、疼痛和抽筋等多种症状组合，这些症状会影响他们的日常功能。在CIPN有限的预防和治疗选择中，运动已成为一种有前景的新干预措施，迄今为止已有大约二十多项临床试验对其进行了研究。随着更多研究测试并表明运动对治疗CIPN的疗效，深入了解运动效果的作用机制变得愈发关键，以便对运动进行调整，从而更好地治疗CIPN症状，并确定谁将从中获益最大。为了澄清目前关于运动对CIPN影响的不明确之处，我们综述了关键的潜在机制（如神经生理学和社会心理因素）、介导因素（如抗炎细胞因子、自我效能感和社会支持）以及调节因素（如年龄、性别、体重指数、身体素质、运动剂量、运动依从性和运动时间），这些因素可能有助于阐明运动与CIPN改善之间的关系。我们的综述基于对CIPN患者、其他类型神经病变患者以及健康成年人进行运动测试的研究。本文所呈现的讨论内容可用于：（1）指导肿瘤学家预测哪些症状最适合通过特定的运动方案来靶向治疗；（2）使临床医生能够根据患者的具体特征量身定制运动处方；（3）为未来关于运动与CIPN关系的研究和生物标志物提供信息。
