Neurologic symptoms and signs in cancer patients have several causes, such as metastatic involvement of the central nervous system (CNS) or peripheral nervous system, paraneoplastic disorders, or therapy-related neurotoxicity. Peripheral and central neurotoxicity is a common side effect of chemotherapeutic drugs. Vinca alkaloids, cisplatin, and the taxanes are among the most important agents inducing peripheral neurotoxicity, whereas, for instance, methotrexate and ifosfamide are primarily known for their central neurotoxic side effects. Neurotoxicity due to chemotherapy is frequently dose related. In most chemotherapeutic regimens, bone marrow toxicity is the major limiting factor. Strategies, such as bone marrow transplantation and the administration of growth factors, are being developed to overcome the toxic effects of chemotherapy on bone marrow. This will allow use of higher chemotherapy doses and, consequently, the risk of neurotoxicity will also increase. Peripheral and central neurotoxicities caused by several cytostatic compounds are reviewed in this chapter together with some data on neuroprotection. Comprehensive reviews of neurotoxic effects of chemotherapy have been written by several authors [1,2]. An overview of chemotherapeutic agents causing peripheral and/or central neurotoxicity is given in Table 29–1.
KeywordsNerve Growth Factor Dorsal Root Ganglion Peripheral Neuropathy Autonomic Neuropathy Sensory Neuropathy
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