Journal ArticleDOI
Chemotherapy-induced neuropathy.
Reads0
Chats0
TLDR
The neurologist managing the cancer patient who develops neuropathy must answer a series of important questions as follows: Are the symptoms due to peripheral neuropathy?Abstract:
Neurotoxic side effects of cancer therapy are second in frequency to hematological toxicity. Unlike hematological side effects that can be treated with hematopoietic growth factors, neuropathies cannot be treated and protective treatment strategies have not been effective. For the neurologist, the diagnosis of a toxic neuropathy is primarily based on the case history, the clinical and electrophysiological findings, and knowledge of the pattern of neuropathy associated with specific agents. In most cases, toxic neuropathies are length-dependent, sensory, or sensorimotor neuropathies often associated with pain. The platinum compounds are unique in producing a sensory ganglionopathy. Neurotoxicity is usually dependent on cumulative dose. Severity of neuropathy increases with duration of treatment and progression stops once drug treatment is completed. The platinum compounds are an exception where sensory loss may progress for several months after cessation of treatment ("coasting"). As more effective multiple drug combinations are used, patients will be treated with several neurotoxic drugs. Synergistic neurotoxicity has not been extensively investigated. Pre-existent neuropathy may influence the development of a toxic neuropathy. Underlying inherited or inflammatory neuropathies may predispose patients to developing very severe toxic neuropathies. Other factors such as focal radiotherapy or intrathecal administration may enhance neurotoxicity. The neurologist managing the cancer patient who develops neuropathy must answer a series of important questions as follows: (1) Are the symptoms due to peripheral neuropathy? (2) Is the neuropathy due to the underlying disease or the treatment? (3) Should treatment be modified or stopped because of the neuropathy? (4) What is the best supportive care in terms of pain management or physical therapy for each patient? Prevention of toxic neuropathies is most important. In patients with neuropathy, restorative approaches have not been well established. Symptomatic and other management are necessary to maintain and improve quality of life.read more
Citations
More filters
Journal ArticleDOI
Chemotherapy-induced peripheral neuropathy: Prevention and treatment strategies
TL;DR: New evidence strongly suggests that intravenous calcium and magnesium therapy can attenuate the development of oxaliplatin-induced CIPN, without reducing treatment response, and accumulating data suggest that vitamin E may also attenuateThe development of CIPn.
Journal ArticleDOI
Platinum neurotoxicity pharmacogenetics
TL;DR: Findings from the current literature for genetic markers associated with neurotoxicity induced by single-agent and combination platinum chemotherapy have the potential for broad clinical implications if mechanistic associations lead to the development of toxicity modulators to minimize the noxious sequelae of platinum chemotherapy.
Journal ArticleDOI
Chemotherapy-induced peripheral neurotoxicity (CIPN): An update
TL;DR: The features of chemotherapy-induced peripheral neurotoxicity (CIPN) resulting from the administration of these drugs are reviewed with a focus on new classes of promising antineoplastic agents, such as epothilones and proteasome inhibitors.
Journal ArticleDOI
Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature
TL;DR: It is increasingly recognized that BIPN may be a proteasome inhibitor class effect, producing primarily a small fiber and painful, axonal, sensory distal neuropathy.
Journal ArticleDOI
Peripheral neuropathies from chemotherapeutics and targeted agents: diagnosis, treatment, and prevention
TL;DR: Peripheral neuropathies induced by chemotherapy (CIPN) are an increasingly frequent problem, and concepts of rehabilitation need to be implemented to improve the patients' functions and quality of life.
References
More filters
Journal ArticleDOI
A phase 2 study of bortezomib in relapsed, refractory myeloma.
Paul G. Richardson,Bart Barlogie,James R. Berenson,Seema Singhal,Sundar Jagannath,D. Irwin,S. Vincent Rajkumar,Gordan Srkalovic,Melissa Alsina,Raymond Alexanian,David S. Siegel,Robert Z. Orlowski,David J. Kuter,Steven Limentani,Stephanie J. Lee,Teru Hideshima,Dixie Lee Esseltine,Michael Kauffman,Julian Adams,David P. Schenkein,Kenneth C. Anderson +20 more
TL;DR: Bortezomib, a member of a new class of anticancer drugs, is active in patients with relapsed multiple myeloma that is refractory to conventional chemotherapy.
Journal ArticleDOI
Estimates of the worldwide incidence of 25 major cancers in 1990
TL;DR: There are large differences in the relative frequency of different cancers by world area, and tobacco smoking and chewing are almost certainly the major preventable causes of cancer today.
Journal ArticleDOI
Levamisole and Fluorouracil for Adjuvant Therapy of Resected Colon Carcinoma
Charles G. Moertel,Fleming Tr,Macdonald Js,Daniel G. Haller,John A. Laurie,Phyllis J. Goodman,James S. Ungerleider,W A Emerson,Douglass C. Tormey,John H. Glick +9 more
TL;DR: Adjuvant therapy with levamisole and fluorouracil should be standard treatment for Stage C colon carcinoma, and this approach should be readily adaptable to conventional medical practice.
Journal ArticleDOI
Estimates of the worldwide mortality from 25 cancers in 1990.
TL;DR: It is estimated that 20% of all cancer deaths (1 million) could be prevented by eliminating tobacco smoking, and the potential impact of preventive practices is indicated.
Journal ArticleDOI
A Practical Two-Step Quantitative Clinical and Electrophysiological Assessment for the Diagnosis and Staging of Diabetic Neuropathy
Eva L. Feldman,Martin J. Stevens,P. K. Thomas,Morton B. Brown,Nicola Canal,Douglas A. Greene +5 more
TL;DR: The results indicate that the MNSI is a good screening tool for diabetic neuropathy and that the MDNS coupled with nerve conductions provides a simple means to confirm this diagnosis.
Related Papers (5)
Studies of peripheral sensory nerves in paclitaxel-induced painful peripheral neuropathy: evidence for mitochondrial dysfunction.
Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline
Dawn L. Hershman,Christina Lacchetti,Robert H. Dworkin,Ellen M. Lavoie Smith,Jonathan Bleeker,Guido Cavaletti,Cynthia Chauhan,Patrick Gavin,Antoinette Lavino,Maryam B. Lustberg,Judith A. Paice,Bryan P. Schneider,Mary Lou Smith,Thomas J. Smith,Shelby A. Terstriep,Nina D. Wagner-Johnston,Kate Bak,Charles L. Loprinzi +17 more