Peripheral neuropathy: from guidelines to clinical practise.

IF 2.8 4区 医学 Q2 ONCOLOGY
Current Opinion in Oncology Pub Date : 2025-03-01 Epub Date: 2025-01-15 DOI:10.1097/CCO.0000000000001112
Berit Jordan, Franziska Jahn, Karin Jordan
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引用次数: 0

Abstract

Purpose of review: Chemotherapy-induced peripheral neuropathy (CIPN) is a substantial adverse effect of anticancer therapy. No effective preventive strategies are established in clinical routine, although some forms of cryotherapy or compression therapy seem to be promising. CIPN is difficult to grade objectively and has mostly relied on a clinician- or patient-based rating that is subjective and not easily reproducible.

Recent findings: Recent preclinical and clinical studies showed an indicative hint of serum neurofilaments for axonal damage as a biomarker and might be introduced in clinical practice in the future. Axonal degeneration in toxic neuropathy is triggered by molecular pathways including SARM1. Presence of certain genotypes predispose for developing severe vincristine neuropathy. Still, treatment of CIPN is focused on treating neuropathic pain primarily based on physicians experience. A positive effect of membrane stabilizers such as gabapentinoids could not be shown in a systematic review mostly due to inconsistent study populations. In the treatment and prevention of functional disability, physical exercise including sensorimotor-training and whole-body vibration seems promising.

Summary: More research is needed on quantification of biomarkers indicative for axonal degeneration prior to CIPN symptom expression. All these recent findings should support the health-care team for a patient centred treatment approach.

周围神经病变:从指南到临床实践。
回顾目的:化疗诱导的周围神经病变(CIPN)是抗癌治疗的一个重要不良反应。在临床常规中没有建立有效的预防策略,尽管某些形式的冷冻疗法或压迫疗法似乎很有希望。CIPN很难客观评分,主要依赖于临床医生或患者的主观评分,不易重复。最近的研究发现:最近的临床前和临床研究表明,血清神经丝对轴突损伤有指示性的提示,并可能在未来的临床实践中引入。中毒性神经病的轴突变性是由包括SARM1在内的分子通路引发的。存在某些基因型易患严重长春新碱神经病。尽管如此,CIPN的治疗主要是基于医生的经验来治疗神经性疼痛。由于研究人群不一致,膜稳定剂如加巴喷丁类的积极作用无法在系统评价中显示。在功能性残疾的治疗和预防方面,包括感觉运动训练和全身振动在内的体育锻炼似乎很有希望。总结:在CIPN症状表达之前,需要对轴突变性的生物标志物进行量化研究。所有这些最近的发现都应该支持卫生保健团队采取以患者为中心的治疗方法。
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来源期刊
Current Opinion in Oncology
Current Opinion in Oncology 医学-肿瘤学
CiteScore
6.10
自引率
2.90%
发文量
130
审稿时长
4-8 weeks
期刊介绍: With its easy-to-digest reviews on important advances in world literature, Current Opinion in Oncology offers expert evaluation on a wide range of topics from sixteen key disciplines including sarcomas, cancer biology, melanoma and endocrine tumors. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by annotated references detailing the merits of the most important papers.
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