TY - JOUR
T1 - Peripheral neuropathies from chemotherapeutics and targeted agents
T2 - Diagnosis, treatment, and prevention
AU - Grisold, Wolfgang
AU - Cavaletti, Guido
AU - Windebank, Anthony J.
PY - 2012/9
Y1 - 2012/9
N2 - Peripheral neuropathies induced by chemotherapy (CIPN) are an increasingly frequent problem. Contrary to hematologic adverse effects, which can be treated with hematopoetic growth factors, neither prophylaxis nor specific treatment is available, and only symptomatic treatment can be offered. Neurotoxic drugs are becoming a major dose-limiting factor. The epidemiology is still unclear. Several drug-dependent pathogenetic mechanisms exist. CIPN are predominately sensory, length-dependent neuropathies that develop after a typical cumulative dose. Usually, the appearance of CIPN is dose dependent, although in at least 2 drugs (oxaliplatin and taxanes), immediate toxic effects occur. The most frequent substances causing CIPN are platin compounds, vinka alkaloids, taxanes, and bortezomib and thalidomide. The role of synergistic neurotoxicity caused by previously given chemotherapies and concomitant chemotherapies and the role pre-existent neuropathy on the development of a CIPN is not clear. As the number of long-term cancer survivors increases and a new focus on long-term effects of chemotherapy-induced neuropathies emerge, concepts of rehabilitation need to be implemented to improve the patients' functions and quality of life.
AB - Peripheral neuropathies induced by chemotherapy (CIPN) are an increasingly frequent problem. Contrary to hematologic adverse effects, which can be treated with hematopoetic growth factors, neither prophylaxis nor specific treatment is available, and only symptomatic treatment can be offered. Neurotoxic drugs are becoming a major dose-limiting factor. The epidemiology is still unclear. Several drug-dependent pathogenetic mechanisms exist. CIPN are predominately sensory, length-dependent neuropathies that develop after a typical cumulative dose. Usually, the appearance of CIPN is dose dependent, although in at least 2 drugs (oxaliplatin and taxanes), immediate toxic effects occur. The most frequent substances causing CIPN are platin compounds, vinka alkaloids, taxanes, and bortezomib and thalidomide. The role of synergistic neurotoxicity caused by previously given chemotherapies and concomitant chemotherapies and the role pre-existent neuropathy on the development of a CIPN is not clear. As the number of long-term cancer survivors increases and a new focus on long-term effects of chemotherapy-induced neuropathies emerge, concepts of rehabilitation need to be implemented to improve the patients' functions and quality of life.
KW - cancer treatment
KW - chemotherapy induced neuropathy
KW - long-term effects
KW - neurotoxicity
UR - http://www.scopus.com/inward/record.url?scp=84868008289&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84868008289&partnerID=8YFLogxK
U2 - 10.1093/neuonc/nos203
DO - 10.1093/neuonc/nos203
M3 - Article
C2 - 23095830
AN - SCOPUS:84868008289
SN - 1522-8517
VL - 14
SP - iv45-iv54
JO - Neuro-oncology
JF - Neuro-oncology
IS - SUPPL.4
ER -