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2017 ; 10
(ä): 174
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Pathophysiology of Chemotherapy-Induced Peripheral Neuropathy
#MMPMID28620280
Starobova H
; Vetter I
Front Mol Neurosci
2017[]; 10
(ä): 174
PMID28620280
show ga
Chemotherapy-induced neuropathy is a common, dose-dependent adverse effect of
several antineoplastics. It can lead to detrimental dose reductions and
discontinuation of treatment, and severely affects the quality of life of cancer
survivors. Clinically, chemotherapy-induced peripheral neuropathy presents as
deficits in sensory, motor, and autonomic function which develop in a glove and
stocking distribution due to preferential effects on longer axons. The
pathophysiological processes are multi-factorial and involve oxidative stress,
apoptotic mechanisms, altered calcium homeostasis, axon degeneration and membrane
remodeling as well as immune processes and neuroinflammation. This review
focusses on the commonly used antineoplastic substances oxaliplatin, cisplatin,
vincristine, docetaxel, and paclitaxel which interfere with the cancer cell
cycle-leading to cell death and tumor degradation-and cause severe acute and
chronic peripheral neuropathies. We discuss drug mechanism of action and
pharmacokinetic disposition relevant to the development of peripheral neuropathy,
the epidemiology and clinical presentation of chemotherapy-induced neuropathy,
emerging insight into genetic susceptibilities as well as current understanding
of the pathophysiology and treatment approaches.