Management of peripheral neuropathy induced by chemotherapy

Maayan Fradkin, Ron Batash, Shiran Elmaleh, Ronen Debi, Pamela Schaffer, Moshe Schaffer, Noam Asna

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations

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 Soci-ety), 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 cannabi-noids, 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.

Original languageEnglish
Pages (from-to)4698-4708
Number of pages11
JournalCurrent Medicinal Chemistry
Volume26
Issue number25
DOIs
StatePublished - 1 Jan 2019

Keywords

  • CIPN
  • Cannabis
  • Chemotherapy
  • Neuropathy
  • Opioid
  • SSNR1
  • TCA

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