Updates in the Treatment of Chemotherapy-Induced Peripheral Neuropathy.
Updates in the Treatment of Chemotherapy-Induced Peripheral Neuropathy.
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DOI：
10.1007/s11864-021-00926-0
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发表时间：
2022-01
影响因子：
4.3
通讯作者：
Lustberg MB
中科院分区：
文献类型：
--
作者：
Mezzanotte JN;Grimm M;Shinde NV;Nolan T;Worthen-Chaudhari L;Williams NO;Lustberg MB
化疗诱导的周围神经病变（CIPN）是与铂类药物、紫杉烷类、长春花生物碱和其他特定药物治疗相关的常见毒性。这种情况的长期后果可能导致患者生活质量下降，并可能导致剂量强度降低，从而对疾病结局产生负面影响。目前还没有针对CIPN的循证预防策略，治疗选择也很有限。然而，随着在预防和治疗环境中收集更多数据，可以利用几种策略来改善患者体验和结果。在治疗前，对患者进行化疗潜在副作用的教育是关键，尽管试验有限，但在化疗前和化疗期间推荐运动和健康的生活方式可能会带来一些整体益处。对于出现疼痛性CIPN的患者，我们的方法是提供度洛沙汀，每日滴定至60 mg。如果在治疗期间出现无法忍受的症状，也可能需要减少化疗剂量。一些患者也可以尝试针灸和物理治疗来帮助解决他们的症状，尽管这可能受到成本，时间承诺和患者动机的限制。此外，由于研究仍在进行中，目前关于这些模式的数据有限。总体而言，在解决CIPN时，有必要在个体层面上接近每位患者，并根据整体身体状况，疾病负担，护理目标和共病健康状况以及尝试不同方法的意愿为他们定制治疗方案。
Chemotherapy-induced peripheral neuropathy (CIPN) is a common toxicity associated with treatment with platinum-based agents, taxanes, vinca alkaloids, and other specific agents. The long-term consequences of this condition can result in decreased patient quality of life and can lead to reduced dose intensity, which can negatively impact disease outcomes. There are currently no evidence-based preventative strategies for CIPN and only limited options for treatment. However, there are several strategies that can be utilized to improve patient experience and outcomes as more data are gathered in the prevention and treatment setting. Before treatment, patient education on the potential side effects of chemotherapy is key, and although trials have been limited, recommending exercise and a healthy lifestyle before and while undergoing chemotherapy may provide some overall benefit. In patients who develop painful CIPN, our approach is to offer duloxetine and titrate up to 60mg daily. Chemotherapy doses may also need to be reduced if intolerable symptoms develop during treatment. Some patients may also try acupuncture and physical therapy to help address their symptoms, although this can be limited by cost, time commitment, and patient motivation. Additionally, data on these modalities are currently limited, as studies are ongoing. Overall, approaching each patient on an individual level and tailoring treatment options for them based on overall physical condition, their disease burden, goals of care and co-morbid health conditions, and willingness to trial different approaches is necessary when addressing CIPN.
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影响因子：
5.2
作者：
Caillaud M;Patel NH;Toma W;White A;Thompson D;Mann J;Tran TH;Roberts JL;Poklis JL;Bigbee JW;Fang X;Gewirtz DA;Damaj MI
通讯作者：
Damaj MI
影响因子：
2.9
作者：
Ben-Horin I;Kahan P;Ryvo L;Inbar M;Lev-Ari S;Geva R
通讯作者：
Geva R
影响因子：
3.1
作者：
Gewandter, J. S.;Fan, L.;Mohile, S. G.
通讯作者：
Mohile, S. G.
影响因子：
3.8
作者：
Courneya, Kerry S.;McKenzie, Donald C.;Segal, Roanne J.
通讯作者：
Segal, Roanne J.
影响因子：
3.1
作者：
Gewandter, Jennifer S.;Mohile, Supriya G.;Heckler, Charles E.;Ryan, Julie L.;Kirshner, Jeffrey J.;Flynn, Patrick J.;Hopkins, Judith O.;Morrow, Gary R.
通讯作者：
Morrow, Gary R.