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常用化疗药物相关的口腔神经病变:一项叙述性综述

Oral Neuropathy Associated with Commonly used Chemotherapeutic Agents: A Narrative Review.

作者信息

Kouri Maria, Rekatsina Martina, Vadalouca Athina, Viswanath Omar, Varrassi Giustino

机构信息

Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.

A Anesthesiology Clinic, Pain Management and Palliative Care Center, Aretaieio University Hospital, School of Medicine, National and Kapodistrian, University of Athens, Athens, Greece.

出版信息

Curr Pain Headache Rep. 2024 Dec;28(12):1209-1217. doi: 10.1007/s11916-024-01305-8. Epub 2024 Jul 25.

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent complication of cytotoxic chemotherapeutic agents; its incidence largely varies, depending on type, dose, agent and preexisting risk factors. Oral-and-perioral-CIPN (OCIPN) is underreported. Neurotoxic agents can cause jaw pain or numbness. This review aims to present available data on OCIPN RECENT FINDINGS: A narrative literature review, following SANRA guidelines was conducted. PubMed and Cochrane databases were searched until September 2023. Articles referring to neuropathy or neuropathic pain due to head and neck cancer, head and neck radiotherapy, oropharyngeal mucositis, infection or post-surgical pain were excluded. Platinum-based chemotherapeutics, taxanes, vinca alkaloids, immunomodulatory and alkylating agents can cause OCIPN. Platinum-based chemotherapeutics can cause orofacial cold sensitivity, orofacial and jaw pain, oral cavity tingling and teeth hypersensitivity. Taxanes may induce oral cavity and tongue numbness and tingling as well as hot hypersensitivity. Vinca alkaloids may cause jaw, teeth and lips pain and oral mucosa hyperalgesia. Immunomodulatory drugs can cause lips, tongue and perioral numbness, while alkylating agents induce tongue and lips tingling and teeth cold-hypersensitivity. Chemotherapy may cause OCIPN due to changes in cellular structure and function, like alterations in membrane receptors and neurotransmission. OCIPN should be documented and physicians, dentists and health care providers should be alerted.

摘要

化疗引起的周围神经病变(CIPN)是细胞毒性化疗药物常见的并发症;其发生率差异很大,取决于药物类型、剂量、制剂及既往存在的风险因素。口腔及口周CIPN(OCIPN)的报告较少。神经毒性药物可导致颌部疼痛或麻木。本综述旨在呈现关于OCIPN的现有数据。最新发现:按照SANRA指南进行了叙述性文献综述。检索了PubMed和Cochrane数据库直至2023年9月。排除了涉及头颈癌、头颈部放疗、口腔黏膜炎、感染或术后疼痛所致神经病变或神经性疼痛的文章。铂类化疗药物、紫杉烷类、长春花生物碱、免疫调节剂和烷化剂可导致OCIPN。铂类化疗药物可引起口面部冷敏感、口面部及颌部疼痛、口腔刺痛和牙齿过敏。紫杉烷类可能诱发口腔和舌部麻木、刺痛以及热敏感。长春花生物碱可能导致颌部、牙齿和嘴唇疼痛以及口腔黏膜痛觉过敏。免疫调节药物可引起嘴唇、舌部和口周麻木,而烷化剂可导致舌部和嘴唇刺痛以及牙齿冷过敏。化疗可能因细胞结构和功能改变,如膜受体和神经传递的改变而导致OCIPN。应记录OCIPN情况,并提醒医生、牙医和医疗保健人员。

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