The Future of Chemotherapy: The Mechanisms and Benefits of Exercise in Taxane-Induced Peripheral Neuropathy

Sumedha Shastry, David Mizrahi, Grace Kanzawa-Lee
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Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side-effect resulting from numerous neurotoxic chemotherapies that damages the peripheral nerves, alters sensations in the hands and feet, causes burning and shooting pains, and impairs a patient’s quality of life (QoL). There are limited established interventions to help improve CIPN symptoms. There is only one pharmacological agent (Duloxetine) for treatment of CIPN; however, it only has mild benefit, signaling a critical need for alternative management options to manage patient symptoms. Multiple studies suggest therapeutic benefits of exercise in cancer care to improve physical and psychological functioning; however, the benefits regarding CIPN symptoms and physical function are less clear. This narrative review synthesizes research articles investigating the effect and mechanisms induced by different exercise programs for patients with taxane-induced peripheral neuropathy (TIPN) symptoms and function. The overall incidence, manifestations, characteristics, and mechanisms of CIPN are also discussed. While some studies in this narrative review demonstrated that exercise programs may have benefits on sensory and motor TIPN symptoms in some but not all patients, there are consistent benefits of improved QoL and physical function across most patients. This narrative review highlights the need for future research to confirm the effects of exercise for TIPN, with a focus on other important components, including the effect of exercise adherence, type, and supervision level.
化疗的未来:紫杉烷诱导周围神经病变的运动机制和益处
化疗引起的周围神经病变(CIPN)是一种剂量限制的副作用,由许多神经毒性化疗引起,它损害周围神经,改变手脚的感觉,引起灼烧和射痛,并损害患者的生活质量(QoL)。帮助改善CIPN症状的现有干预措施有限。治疗CIPN的药物只有一种(度洛西汀);然而,它只有轻微的好处,这表明迫切需要替代的管理方案来管理患者的症状。多项研究表明,在癌症护理中,锻炼可以改善身体和心理功能;然而,对于CIPN症状和身体功能的益处尚不清楚。本文综述了不同运动方案对紫杉烷诱导的周围神经病变(TIPN)症状和功能的影响和机制的研究文章。本文还讨论了CIPN的发病、表现、特点和发病机制。虽然这篇叙述性综述中的一些研究表明,锻炼计划可能对一些但不是所有患者的感觉和运动TIPN症状有好处,但大多数患者的生活质量和身体功能的改善都有一致的好处。这篇叙述性综述强调了未来研究的必要性,以确认运动对TIPN的影响,重点关注其他重要组成部分,包括运动坚持、运动类型和监督水平的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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