Neurotoxicity of Cancer Chemotherapy

Abstract

Neurological dysfunction is a common side effect of many chemotherapy drugs. For several agents neurotoxicity is common, severe, and can be dose-limiting. This is a review of the clinical features of chemotherapy-induced syndromes involving the central and peripheral nervous systems.

Effect of Cancer Treatment on Neural Stem and Progenitor Cells

“…[72][73][74][75] Non-enhancing, confluent, periventricular white matter lesions, necrosis, ventriculomegaly, and cortical atrophy characterize this syndrome. While progressive cognitive deficits are frequently present clinically, white matter abnormalities seen 76,77 Additionally, adverse neurological effects have been observed with virtually all categories of chemotherapeutic agents, 67,68,[78][79][80] including antimetabolites (e.g., cytosine arabinoside, 5-FU, and methotrexate), DNA cross-linking agents (e.g., carmustine and cisplatin), mitotic inhibitors (e.g., vincristine) and antihormonal agents.…”

Lhermitte's sign: Review with special emphasis in oncology practice

“…It is usually cumulative and dose dependent. Chemotherapy related neurotoxicity is potentially reversible and resolves gradually after termination of treatment [44][45][46][47][48]. Preexisting diabetes mellitus, chronic alcoholism, other disorders predisposing to neuropathies or administration of concurrent neurotoxic drugs increase the risk of neurotoxicity associated with chemotherapy.…”

“…They can cause different forms of neurotoxicity depending on the site of involvement. The chemotherapy induced neurotoxicity can be acute, subacute or chronic [44][45][46][47][48]. It is usually cumulative and dose dependent.…”

“…Chemotherapy related neurotoxicity can substantially impair the patient's quality of life. Among the many chemotherapeutic agents, taxanes, platinum compounds and vinca alkaloids are the most important ones associated with neurotoxicity [44][45][46][47][48]. Chemotherapeutic agents can be toxic either at the central nervous system or at the peripheral nervous system.…”

Barriers to pain assessment and management in cancer survivorship

“…Chemotherapy-related chronic pain syndromes include painful peripheral neuropathy, as well as osteonecrosis or avascular necrosis from chronic corticosteroid use as premedications in chemotherapeutic regimens [12][13][14]. The development of persistent peripheral neuropathy is largely dependent on factors such as age, co-morbidities (i.e., diabetes), cumulative dose of chemotherapy, and impaired drug metabolism [15,16]. Avascular necrosis secondary to corticosteroid use often occurs in the femoral or humoral head which leads to decreased range of motion, pain with movement, and arthritis [5].…”