摘要
目的:总结化疗所致周围神经病变(CIPN)研究的历史、现状及面临的问题。方法:应用PubMed全文数据库检索系统,以"周围神经病变、周围神经毒性、化疗和癌症"等为关键词,检索2006-01-2012-09相关文献。纳入标准:1)CIPN发生机制;2)临床表现;3)评估以及防治现状。根据纳入标准符合分析的文献24篇。结果:化疗所致周围神经病变是抗肿瘤药物最常见毒副作用之一,其中紫杉烷类和顺铂治疗人群发生率为60%。CIPN导致患者活动功能受限,严重影响生活质量,限制化疗剂量甚至终止化疗。其发病机制、发生率、表现类型以及严重程度的多样性归咎于药物毒性成分不同。目前探索CIPN危险因素的研究日益增多,通过基因型确认患者是否为高风险人群为未来研究热点。CIPN权威评价标准尚未确立。结论:临床尚无有效药物预防CIPN发生或改善病程,只能通过调整化疗方案甚至停用限制神经毒性。通过对CIPN发生机制、临床特征和严重程度的研究,进一步了解其病理生理变化,发现预测因子、早期神经病变标志、更敏感的诊断技术和有效的神经保护策略,提高患者生存质量。
OBJECTIVE：To summarize the research progress of the past,present and future of the chemotherapy in duced peripheral neuropathy（CIPN）. METHODS：References for this Review were identified by searches of PubMed for ar ticles published from J AN 2006 to SEP 2012, using ＂peripheral neuropathy, peripheral neurotoxicity, chemotherapy, canc er＂ as keywords. Including standards：the mechanistic and clinical aspects of CIPN are considered, also with the assessment of the patient＇s condition,and the current status of neuroprotection and treatment options. According to the standards,24 articals were analyzed. RESULTS： Chemotherapy-induced peripheral neuropathy is the most prevalent neurological complication of cancer treatment,incidences of up to 60% have been estimated of patients treated with cisplatin and Taxanes. CIPN impairs functional capacity, compromises the quality of life and results in dose reduction even cessation of chemotherapy. Our knowledge of the mechanisms underlying CIPN is incomplete, but the various neurotoxic compounds might contribute to variations in the mechanisms of damage, incidence of CIPN, the type of neurotoxicity, and severity of the clinical presentation. Research into the identification of risk factors for individual patients is growing. A future avenue of investigation includes the identification of patients at low er or higher risk based on their genotype. Best tools for CIPN assessment are not defined. CONCLUSTIONS： There is still no consensus on how to prevent CIPN or improve its long-term course. Early recognition and dose reduction/discontinuation of the offen- ding agent is the only way to minimise the development of CIPN. Thorough investigation of the features,mechanisms and severity of CIPN is important for a better understanding of its pathophysiology to investigate prognostic factors, early neuropathy biomark ers,more sensitive diagnostic techniques,and new drugs and neuroprotective strategies can protect patients against neuropathy in duced by chemotherapy.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第14期1123-1126,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
国家自然科学基金青年项目(81001026)
黑龙江省教育厅骨干教师基金(125G038)
关键词
周围神经病变
周围神经毒性
化疗
肿瘤
综述文献
peripheral neuropathy
peripheral neurotoxicity
chemotherapy
cancer
review literture
