Selected neurological complications of oncological treatment — literature overview (original) (raw)

Cancer-treatment-induced neurotoxicity—focus on newer treatments

Nature Reviews Clinical Oncology, 2015

Neurotoxicity from traditional chemotherapy and radiotherapy is widely recognized. The adverse effects of newer therapeutics such as biological and immunotherapeutic agents are less familiar and they are also associated with significant neurotoxicity in the central and peripheral nervous systems. This review addresses the main toxicities of cancer treatment by symptom with a focus on the newer therapeutics. Recognition of these patterns of toxicity is important as drug discontinuation or dose adjustment may prevent further neurologic injury. Also, knowledge of these toxicities helps to differentiate treatment-related symptoms from progression of cancer or its involvement of the nervous system.

Neurologic complications of chemotherapy and other newer and experimental approaches

Handbook of clinical neurology, 2014

Neurologic complications of conventional cytototxic agents as well as those from monoclonal antibodies and targeted therapies are increasingly observed in patients with cancer. The major categories are represented by alkylating agents (platinum compounds, ifosfamide, procarbazine, thiotepa), mitotic spindle inhibitors (vinca alkaloids, taxanes, etoposide, teniposide), proteasome inhibitors (bortezomib), antibiotics, antimetabolites, thalidomide, lenalidomide, topoisomerase inhibitors, interferon-α, hormones, bevacizumab, trastuzumab, and small tyrosine kinase inhibitors. Peripheral neuropathy is a common adverse effect of a number of chemotherapeutic drugs and often represents a critical factor limiting an adequate dose-intensity of chemotherapy. Regarding the central nervous system (CNS), it is vulnerable to many forms of toxicity from chemotherapeutic agents, including encephalopathy syndromes and confusional states, seizures, headache, cerebrovascular complications, visual loss, ...

Neurologic Complications of Chemotherapy and Radiation Therapy

Elsevier eBooks, 2014

Purpose of Review: Nervous system injury from cancer therapeutics is second only to myelosuppression as the most common toxicity caused by chemotherapy and radiation therapy. Recent Findings: Neurologic complications can be seen throughout the course of cancer diagnosis and treatment; some toxicities may not develop for years or even decades after completion of treatment, making diagnosis challenging. However, early recognition is critical as modification of therapeutic regimens can diminish long-term consequences of nervous system injury and improve a patient's quality of life. This article addresses the most common neurologic complications seen as a consequence of chemotherapy and radiation therapy in patients with systemic cancer. These common toxicities are likely to be seen with increasing frequency as patients with systemic cancer are living longer and receiving multiple courses of antineoplastic regimens, some of which are lifelong. Summary: Neurotoxicity from cancer therapeutics is common, and early recognition is critical to proper diagnosis and intervention.

Chemotherapy-induced peripheral neurotoxicity

2010

With a 3-fold increase in the number of cancer survivors noted since the 1970s, there are now over 28 million cancer survivors worldwide. Accordingly, there is a heightened awareness of long-term toxicities and the impact on quality of life following treatment in cancer survivors. This review will address the increasing importance and challenge of chemotherapy-induced neurotoxicity, with a focus on neuropathy associated with the treatment of breast cancer, colorectal cancer, testicular cancer, and hematological cancers. An overview of the diagnosis, symptomatology, and pathophysiology of chemotherapy-induced peripheral neuropathy will be provided, with a critical analysis of assessment strategies, neuroprotective approaches, and potential treatments. The review will concentrate on neuropathy associated with taxanes, platinum compounds, vinca alkaloids, thalidomide, and bortezomib, providing clinical information specific to these chemotherapies. CA Cancer J Clin 2013;63:419-437.

Chemotherapy-Induced Peripheral Neurotoxicity in CancerSurvivors: An Underdiagnosed Clinical Entity?

Systemic chemotherapy is a cornerstone of the modern medical management of cancer, although its use is limited by toxicity on normal tissues and organs, including the nervous system. Long-surviving or cured people strongly require a high level of wellness in addition to prolongation of life (the concept of the quality of survival), but neurologic dysfunction can severely affect daily life activities. Chemotherapy-related peripheral neurotoxicity is becoming one of the most worrisome long-term side effects in patients affected by a neoplasm. The central nervous system has a limited capacity to recover from injuries, and it is not surprising that severe damage can determine long-term or permanent neurologic dysfunction. However, the peripheral nervous system also can be permanently damaged by anticancer treatments despite its better regeneration capacities, and the effect on patients' daily life activities might be extremely severe. However, only recently, the paradigms of peripheral neurotoxicity reversibility have been scientifically challenged, and studies have been performed to capture the patients' perspectives on this issue and to measure the effect of peripheral neurotoxicity on their daily life activities. Despite these efforts, knowledge about this problem is still largely incomplete, and further studies are necessary to clarify the several still-unsettled aspects of long-term peripheral neurotoxicity of conventional and targeted anticancer chemotherapy.

Patients' and physicians' interpretation of chemotherapy‐induced peripheral neurotoxicity

Journal of the Peripheral Nervous System, 2019

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Chemotherapy and Polyneuropathies

Patients with oncological diseases need to receive the most effective anti-cancer therapy. To achieve this, usually a combination of surgery, radiotherapy (RT), and chemotherapy, also with biologicals with an increased use of targeted therapies, is applied. Like most other side effects of therapy, such as nausea, haematotoxicity can be managed but the increased use of neurotoxic drugs and the development of CIPN are becoming major dose-limiting factors.