Universität zu Köln

Geber, C., Boehmerle, W., Lehmann, H. C. and Hagenacker, T. (2016). Assessment and Therapy of Chemotherapy-Induced Polyneuropathy: Update 2016. Aktuelle Neurol., 43 (3). S. 171 - 179. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-9428

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Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and painful condition in patients undergoing treatment with commonly used agents such as platinum compounds, vinca alcaloids, taxanes, small molecules and antibody-based therapies. The incidence of CIPN is increasing as a consequence of better cancer treatments becoming available and increasing use of chemotherapy, and because it is a more frequently occurring side-effect with use of new chemotherapeutics. The mechanisms underlying this condition are diverse, and include an array of molecular and cellular contributions. Processes influenced by CIPN include increased expression of inflammatory mediators, changes in ion channels and neurotransmission, as well as changes in intracellular signaling and structures. Structural deficits in dorsal root ganglia and sensory nerves cause symptoms such as sensory loss, paresthesia, dysesthesia, numbness as well as neuropathic pain that result in patient suffering and also limit the therapeutic efficiency with a severe impairment of quality of life. DNA damage, alterations in cellular system repairs, mitochondrial changes, increased intracellular reactive oxygen species, glutamate signaling, MAP-kinases and nociceptor ectopic activation are among the events that trigger the onset of peripheral neurotoxicity and neuropathic pain. The diagnosis of CIPN is made principally on clinical grounds, and it is characterized by predominantly sensory symptoms. CIPN assessment relies mainly on patient-oriented questionnaires, but an international effort is ongoing to assess reliable and objective means to assess small and large fiber impairment. If CIPN occurs, the only effective strategies are dose reduction or discontinuation of chemotherapy. However, symptomatic treatment of mainly neuropathic pain symptoms is available and effective. The purpose of this review is to examine the basic mechanisms of neuropathy and currently available treatment options in the context of CIPN.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Geber, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehmerle, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, H. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagenacker, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-279750
DOI:	10.1055/s-0035-1569271
Journal or Publication Title:	Aktuelle Neurol.
Volume:	43
Number:	3
Page Range:	S. 171 - 179
Date:	2016
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1438-9428
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INDUCED PERIPHERAL NEUROPATHY; METASTATIC BREAST-CANCER; RELAPSED MULTIPLE-MYELOMA; RANDOMIZED PHASE-III; ACUTE PAIN SYNDROME; QUALITY-OF-LIFE; INDUCED NEUROTOXICITY; BRENTUXIMAB VEDOTIN; OVARIAN-CANCER; COMBINATION CHEMOTHERAPY Multiple languages Clinical Neurology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27975