Affiliation:
1. Department of Oncology, Barzilai Medical Center, Ashkelon, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
2. Department of Orthopedic Surgery, Barzilai Medical Center, Ashkelon, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
3. Department of Radiation Therapy, Bad Trissl, Oberaudorf Germany, and Faculty of Medicine, University of Oradea, Romania
Abstract
Background:
Chemotherapy-induced peripheral neuropathy (CIPN) is considered
a severe side effect of therapeutic agents with limited treatment options. The incidence of
CIPN in cancer patients is approximately 3–7% in cytostatic monotherapy and as high as 38%
in cases of polychemotherapy. The prevalence of CIPN was found to be 68% within the first
month of chemotherapy treatment. In some cases, CIPN can resolve, partially or completely,
after completion of the treatment; in other cases, it can remain for a long time and affect the
patient's quality of life.
Objective:
The aim of this study is to present up-to-date data regarding available treatment
options for the management of CIPN.
Materials and Methods:
The up-to-date guidelines of ESMO (European Society for Medical
Oncology), ASCO (American Society of Clinical Oncology), ONS (Oncology Nursing Society),
NCI (National Cancer Institute), and NCCN (National Comprehensive Cancer Network)
were reviewed and included in the manuscript.
Results:
The use of tricyclic antidepressant (TCA), selective serotonin norepinephrine reuptake
inhibitor (SSNRI), pregabalin, and gabapentin are recommended as first-line treatment.
Other treatment options were offered as second and third lines of treatment (lidocaine patches,
capsaicin high-concentration patches, tramadol, and strong opioids, respectively); however,
lower significance was demonstrated. Inconclusive results were found in the use of cannabinoids,
drug combinations, antiepileptics, antidepressants, and topical drugs.
Conclusion:
TCA, other antidepressants, and opioids could be recommended as treatment.
Yet, we could not recommend an ideal therapeutic agent for the prevention or treatment of
CIPN. Therefore, CIPN continues to be a challenge to clinicians and our patients.
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology,Molecular Medicine,Drug Discovery,Biochemistry,Organic Chemistry
Reference77 articles.
1. Jensen T.S.; Baron R.; Haanpää M.; Kalso E.; Loeser J.D.; Rice A.S.C.; Treede R.D.; A new definition of neuropathic pain. Pain 2011,152(10),2204-2205
2. Umapathi T.; Chaudhry V.; Toxic neuropathy. Curr Opin Neurol 2005,18(5),574-580
3. Addington J.; Freimer M.; Chemotherapy-induced periph- eral neuropathy: an update on the current understanding. F1000 Res 2016,5,1466
4. Kanbayashi Y.; Hosokawa T.; Peripheral neuropathies especially in cancer patients: focus on chemotherapy- induced peripheral neuropathies and post-herpetic neuralgia. Int J Cancer Res Prev 2015,8(4),8566
5. Grisold W.; Cavaletti G.; Windebank A.J.; Peripheral neuropathies from chemotherapeutics and targeted agents: diagnosis, treatment, and prevention. Neuro-oncol 2012,14(Suppl. 4),iv45-iv54