化疗引起周围神经病变的研究进展

Research progress of peripheral nerve neuropathy induced by chemotherapy

背景 随着化疗药物在肿瘤治疗中的广泛使用，化疗引起的毒副反应对肿瘤患者的治疗及生活带来不良影响。其中化疗引起周围神经病变（chemotherapy-induced peripheral neuropathy, CIPN）是最常见的毒副反应之一，表现为患者感觉、运动和自主神经系统功能障碍，常常伴有神经病理性疼痛。 目的 了解CIPN的临床特点及其发生机制。 内容 目前常使用的化疗药物，如紫杉醇、铂类化疗药物和长春新碱，作用于线粒体、离子通道、神经炎症和外周神经结构，可能引起感觉、运动和自主神经不同程度的功能障碍。至今，已经通过药物治疗来缓解CIPN引起的功能障碍，但仍需进一步研究开发新的药物以达到理想治疗效果。 趋向 化疗药物的使用需警惕CIPN的发生，CIPN的机制仍未完全明了，仍需深入研究。

Background Chemotherapy drugs have been more and more frequently used in cancer treatment. In addition to controlling cancer growth, these drugs exert strong toxic and side-effects. Chemotherapy-induced peripheral neuropathy（CIPN） is one of the most common adverse reactions. The major manifestations include sensory, motor and autonomic nervous system dysfunction. Some patients are also suffered from neuropathic pain. Objective To review the clinical characteristics and potential mechanisms underlying CIPN. Content Currently available chemotherapy drugs, including Taxanes, platinum chemotherapy drugs, and vincristine, cause diverse dysfunctions in sensory, motor, and autonomous systems, with diversified severity. These symptoms may be associated with the detrimental actions of chemotherapy drugs on mitochondrial, ion channels, neuroinflammation, and the structures of peripheral nerves. CIPN has been treated with drugs that could reverse the above-mentioned dysfunctions. But further studies are required to develop new drugs to achieve ideal therapeutic efficacy. Trend Prescribers of chemotherapy drugs should be aware of CIPN. Although the mechanisms of CIPN remain elusive, efforts are demanded to control its symptoms and improve its prognosis.