化疗诱导的周围神经病变诊治中国专家共识(2022版)

Chinese expert consensus on the diagnosis and treatment of chemotherapy-induced peripheral neuropathy(2022 edition)

化疗诱导的周围神经病变(CIPN)是常见且严重的临床问题,多呈剂量依赖型特征,越来越多的恶性肿瘤患者在化疗后经历CIPN,多数患者仅能部分恢复且症状长期持续,严重影响其生活质量。CIPN可用且有效的临床治疗策略非常有限,肿瘤专科医师经常被迫减少或停用诱发神经不良反应的化疗药物,然而减量或停用化疗药物可能会对患者预后产生不良影响。目前CIPN面临的挑战包括深入探索其病理机制、化疗药物剂量阈值、风险预测模型等,需要完善CIPN诊断标准和工具,优化有效规范的CIPN预防和治疗方案,并为临床诊断和治疗CIPN提供更多决策证据。为此,中国抗癌协会肿瘤支持治疗专业委员会和中国抗癌协会肿瘤临床化疗专业委员会组织专家对文献进行分析和讨论,形成化疗诱导的周围神经不良反应诊治中国专家共识(2022版),以指导临床实践。

Chemotherapy-induced peripheral neuropathy(CIPN)is a serious clinical problem and challenging for oncologists.CIPN is often a persistent adverse consequence of certain chemotherapeutic agents and more cancer survivors will experience CIPN leading to chronic pain and worsening quality of life.However,the available and effective strategies for clinical treatment of CIPN are very limited.Oncologists are frequently obliged to decrease or stop neurotoxic anticancer drugs,with a possible deleterious impact on the oncological prognostic.The challenges faced by CIPN include further study on the pathological mechanism,dose threshold,incidence,risk factors and clinical characteristics of CIPN;lack of diagnostic criteria and tools of CIPN;lack of effective and standardized CIPN prevention and treatment programs.The current update of research results on these challenging issues of CIPN will provide more decision-making evidence for oncologists to diagnose and treat CIPN.Therefore,Committee of Neoplastic Supportive-Care of China Anti-Cancer Association and Cancer Clinical Chemotherapy Committee of China Anti-Cancer Association convenes some experts to summarize the recent literatures and discuss to reach the consensus about recommendations for the definition,pathophysiological mechanism,assessment,prevention,and treatment of CIPN.