An Overview of Chemotherapy-Induced Peripheral Neuropathy

2008 ◽  
Vol 21 (2) ◽  
pp. 138-145 ◽  
Author(s):  
Jose R. Murillo ◽  
James E. Cox ◽  
Michael S. Oholendt
Keyword(s):  
Adverse Event ◽  
Peripheral Neuropathy ◽  
Positive Impact ◽  
Chemotherapeutic Agents ◽  
Patient Specific ◽  
Drug Discontinuation ◽  
Neurologic Complication ◽  
Patients With Cancer ◽  
Neurological Adverse Event

Peripheral neuropathy remains a major limitation of chemotherapeutic agents used in cancer treatment. This neurologic complication from chemotherapy occurs frequently and can be debilitating. Although difficult to predict, both chemotherapeutic and patient-specific risk factors may contribute to this adverse event. Symptoms of peripheral neuropathy may appear acutely after treatment or persist chronically upon drug discontinuation. The taxanes, vinca alkaloids, and immunomodulatory drugs commonly cause peripheral nervous system toxicity. Prompt recognition and evaluation of this neurological adverse event by those who provide care to patients with cancer can prove to have a positive impact on the quality of life of those patients.

Premedications for Cancer Therapies: A Primer for the Hematology/Oncology Provider

2021 ◽  
Vol 12 (8) ◽  
Author(s):  
Amber Clemmons, PharmD, BCOP ◽  
Arpita Gandhi, PharmD, BCOP ◽  
Andrea Clarke, PharmD ◽  
Sarah Jimenez, APN-BC, AGACNP, AOCNP ◽  
Thuy Le, MD ◽  
...  
Keyword(s):  
Best Practices ◽  
Adverse Events ◽  
Chemotherapeutic Agents ◽  
Patient Specific ◽  
Cancer Therapies ◽  
Quality Of Data ◽  
Advanced Practitioner ◽  
Patients At Risk ◽  
Radiation Induced

Chemotherapeutic agents and radiation therapy are associated with numerous potential adverse events (AEs). Many of these common AEs, namely chemotherapy- or radiation-induced nausea and vomiting, hypersensitivity reactions, and edema, can lead to deleterious outcomes (such as treatment nonadherence or cessation, or poor clinical outcomes) if not prevented appropriately. The occurrence and severity of these AEs can be prevented with the correct prescribing of prophylactic medications, often called “premedications.” The advanced practitioner in hematology/oncology should have a good understanding of which chemotherapeutic agents are known to place patients at risk for these adverse events as well as be able to determine appropriate prophylactic medications to employ in the prevention of these adverse events. While several guidelines and literature exist regarding best practices for prophylaxis strategies, differences among guidelines and quality of data should be explored in order to accurately implement patient-specific recommendations. Herein, we review the existing literature for prophylaxis and summarize best practices.

scholarly journals Peripheral Neuropathy and Pain Caused by Cancer Chemotherapy

2021 ◽  
Vol 39 (1) ◽  
pp. 1-9
Author(s):  
Kyomin Choi ◽  
Jeeyoung Oh
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Clinical Characteristics ◽  
Proteasome Inhibitors ◽  
Chemotherapeutic Agents ◽  
Vinca Alkaloids ◽  
Platinum Compounds ◽  
Medical Environment ◽  
Preventive Methods

Peripheral neuropathy and pain are common adverse effects of chemotherapy, which incidence are rising significantly commensurate with extension of survival period in cancer patients. Chemotherapy-induced peripheral neuropathy is caused by most commonly used chemotherapeutic agents including platinum compounds, taxenes, proteasome inhibitors, thalidomide, and vinca alkaloids. Management of neuropathy and pain caused by chemotherapy is still challenging due to there is no proven therapies and preventive methods. The pain and its impact are becoming a main deterioration factor in quality of life and economic burden in our society. We review the mechanism, clinical characteristics, updated evidence of possible management of neuropathy and pain caused by traditional chemotherapeutic agents for contributing to the application of clinicians in their actual medical environment.

scholarly journals Neuroinflammatory Process Involved in Different Preclinical Models of Chemotherapy-Induced Peripheral Neuropathy

2021 ◽  
Vol 11 ◽  
Author(s):  
Giulia Fumagalli ◽  
Laura Monza ◽  
Guido Cavaletti ◽  
Roberta Rigolio ◽  
Cristina Meregalli
Keyword(s):  
Peripheral Neuropathy ◽  
Proteasome Inhibitors ◽  
Chemotherapeutic Agents ◽  
Peripheral Neuropathies ◽  
Drg Neurons ◽  
Toxic Agent ◽  
Cytokines And Chemokines ◽  
Secretion Of Mediators ◽  
Blood Brain Barrier Integrity

Peripheral neuropathies are characterized by nerves damage and axonal loss, and they could be classified in hereditary or acquired forms. Acquired peripheral neuropathies are associated with several causes, including toxic agent exposure, among which the antineoplastic compounds are responsible for the so called Chemotherapy-Induced Peripheral Neuropathy (CIPN). Several clinical features are related to the use of anticancer drugs which exert their action by affecting different mechanisms and structures of the peripheral nervous system: the axons (axonopathy) or the dorsal root ganglia (DRG) neurons cell body (neuronopathy/ganglionopathy). In addition, antineoplastic treatments may affect the blood brain barrier integrity, leading to cognitive impairment that may be severe and long-lasting. CIPN may affect patient quality of life leading to modification or discontinuation of the anticancer therapy. Although the mechanisms of the damage are not completely understood, several hypotheses have been proposed, among which neuroinflammation is now emerging to be relevant in CIPN pathophysiology. In this review, we consider different aspects of neuro-immune interactions in several CIPN preclinical studies which suggest a critical connection between chemotherapeutic agents and neurotoxicity. The features of the neuroinflammatory processes may be different depending on the type of drug (platinum derivatives, taxanes, vinca alkaloids and proteasome inhibitors). In particular, recent studies have demonstrated an involvement of the immune response (both innate and adaptive) and the stimulation and secretion of mediators (cytokines and chemokines) that may be responsible for the painful symptoms, whereas glial cells such as satellite and Schwann cells might contribute to the maintenance of the neuroinflammatory process in DRG and axons respectively. Moreover, neuroinflammatory components have also been shown in the spinal cord with microglia and astrocytes playing an important role in CIPN development. Taking together, better understanding of these aspects would permit the development of possible strategies in order to improve the management of CIPN.

scholarly journals Efficacy of Contact Needle Therapy for Chemotherapy-Induced Peripheral Neuropathy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Keiko Ogawa ◽  
Masao Ogawa ◽  
Koji Nishijima ◽  
Masaki Tsuda ◽  
Genichi Nishimura
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Peripheral Neuropathy ◽  
Breakthrough Pain ◽  
Chemotherapeutic Agents ◽  
Discontinuation Of Treatment ◽  
Before And After ◽  
The Common ◽  
Adequate Sample Size

Cancer chemotherapy-induced peripheral neuropathy (CIPN) often results in discontinuation of treatment with potentially useful anticancer drugs and may deteriorate the patient’s quality of life. This study investigated the effect of contact needle therapy (CNT) on CIPN caused by responsible chemotherapeutic agents as taxanes and oxaliplatin. Six patients with CIPN were treated with CNT. The severity of CIPN was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) version 4 and FACT/GOG-Ntx before and after CNT. After the treatment, all of the patients showed some improvement. Four patients showed apparent improvement in breakthrough pain. One of the cases had difficulty in walking because of CIPN in lower extremities, but after 2 times of CNT, he could walk without pain and could continue the chemotherapy. Although its putative mechanisms remain elusive, CNT has strong potential as an adjunctive therapy in CIPN. Well-designed clinical trials with adequate sample size and power are necessary to confirm the findings of this study.

scholarly journals Electrolytes and Nutritional Element Assessment among Iraqi Cancer Patients Receiving Chemotherapy

2021 ◽  
Vol 9 (A) ◽  
pp. 446-450
Author(s):  
Mohammed Salim Abdulrahman ◽  
Hedef D. El-Yassin ◽  
Nada A. S. Alwan
Keyword(s):  
Cancer Patients ◽  
Positive Impact ◽  
Serum Magnesium ◽  
Significant Rise ◽  
Baseline Measure ◽  
Term Outcome ◽  
Patients With Cancer ◽  
Student’S T ◽  
Level Of Significance

INTRODUCTION: Cancer may lead to abnormalities in electrolyte levels and acid-base disturbances in affected patients that could be induced by the tumor itself or by chemotherapy treatment. Thus, early detection is vital to improve short-term outcome and quality of life. AIM: This study aims to assess the electrolyte and protein changes in cancer patients on chemotherapy. MATERIALS AND METHODS: A cohort study was carried out on 100 newly diagnosed patients with cancer in Al-Amal National Radiation Oncology Hospital in Baghdad, Iraq, during the period from January 2019 to July 2019. An assessment of the studied samples was conducted as a baseline measure before receiving chemotherapy and after the third cycle of that treatment. Quantitative parameters included measurements of serum magnesium, calcium, sodium, chloride, potassium, zinc, Hb1Ac, total protein, and ferritin. Data analysis was carried out using Student’s t-test for variable levels. Level of significance of ≤0.05 was considered as significant. RESULTS: The studied sample comprised 77 females (77%) and 23 males (23%). There were significant decreases in the levels of magnesium and zinc while no significant changes were noted in the levels of other electrolytes. On the other hand, there was a significant decrease in the level of proteins and a significant rise in HBA1c and ferritin. CONCLUSION: Cancer patients on chemotherapy regimens suffer from major changes in the levels of vitamins, elements, and neurotransmitter that affect their lifestyle, survival, and prognosis. Frequent regular monitoring of such changes is required to harvest a positive impact on the lifestyle of cancer patients lifestyle and their outcome.

scholarly journals Impact of Educational Self-efficacy Enhancement Program on Quality of Life, Pain Management, Self-efficiency Behaviors, and Its Impact of Satisfaction Among Adult Diabetic Patients With Peripheral Neuropathy Pain

2020 ◽  
Author(s):  
Jawad.A AHMAD Abu-Shennar ◽  
Nurhan Bayraktar Bayraktar
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Pain Management ◽  
Self Efficacy ◽  
Positive Impact ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Life Questionnaire ◽  
The Impact

Abstract Aims: This study aims to investigate the impact of the educational self-efficacy enhancement program on quality of life, pain management, self-efficiency behaviors, and its impact satisfaction among adult diabetic patients with peripheral neuropathy pain.Materials and methods: This randomized controlled study was conducted at the Jordanian Ministry of Health. during the period from October - March 2020 with 72 adult diabetic patients with peripheral neuropathy pain, after the ethical approval. Study group participants have implemented an educational self-efficacy enhancement program.Demographic data from, Diabetes Self-Efficacy Scale, Quality of Life Questionnaire(EQ-5D), Pain Intensity Scale, and Patient Satisfaction Questionnaire were used in data collection. Results: This study found that the self-efficacy enhancement program had a significantly positive impact on diabetic peripheral neuropathy pain patients’ QoL, pain levels, self-efficiency behaviors, and satisfaction. Conclusion:It is crucial to improve their self-efficacy behaviors and modification of lifestyle and behavioral changes such as appropriate diet, exercise, reduce weight and encouragement stop smoking, and regularly visit treating physicians.

scholarly journals Aprepitant, a novel neurokinin-1 receptor antagonist in management of chemotherapy induces nausea vomiting (CINV) in cancer patients

2019 ◽  
Vol 2 (1) ◽  
pp. 1-4
Author(s):  
Robin George ◽  
E. Sunil Kumar ◽  
Kondi Charitha Reddy ◽  
Shaik Habeebjan
Keyword(s):  
Quality Of Life ◽  
Adverse Event ◽  
Adverse Events ◽  
Treatment Options ◽  
Chemotherapeutic Agents ◽  
Major Adverse Event ◽  
New Class ◽  
Nausea And Emesis ◽  
Neurokinin 1

Nausea and emesis are two major concerns for patients undergoing chemotherapy for cancer. The 5HT3 receptors antagonist ondansetron is the major factor for preventing and treatment for CINV either alone or often is combination with dexamethasone. Even these treatment options exist, CINV remind as major adverse event for all chemotherapeutic agents. The adverse events have major impact on patients quality of life and compliance with treatment. Aprepitant, a novel neurokinin-1 (NK-1) antagonist has been introduced as a new class of drug to prevent CINV. Many trials and studies reveals that comparison of aprepitant to the standard ondansetron and dexamethasone is superior in protecting against CINV. Here this study evaluate and reveals the use and benefits of aprepitant in the management of CINV.

The relationship between chemotherapy-induced peripheral neuropathy and heart rate variability.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 820-820
Author(s):  
Aelee Jang ◽  
Dong Uk Kim
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Peripheral Neuropathy ◽  
Frequency Band ◽  
High Frequency ◽  
Chemotherapeutic Agents ◽  
High Frequency Band ◽  
The Relationship

820 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication related to chemotherapeutic agents and dose accumulation. Initial symptoms are known to be sensory including numbness and pain whereas autonomic symptoms are the latest. Autonomic dysfunction is related to heart rate variability (HRV) change which may precede the symptoms. But, the relationship between CIPN and heart rate variability is not fully evaluated. Therefore, we aimed to evaluate the HRV with CIPN-related questionnaires in patients underwent chemotherapy. Methods: Fifty-five patients with gastrointestinal cancers were enrolled in this cross-sectional cohort study. Patients have received chemotherapeutic agents such as paclitaxel, cisplatin, and oxaliplatin. CIPN was diagnosed using National Cancer Institute Common Toxicity Criteria for Adverse Event (NCI-CTCAE version 4.03). We evaluated the quality of life, CIPN symptom scale, and HRV. Results: Forty-two patients were male (76.4%) and mean age was 63.2 years old. Thirty-nine patients (71.0%) had CIPN of more than grade I according to NCI-CTCAE. Patients with CIPN represented lower physical and role functions. The standard deviation of all normal R-R intervals (SDNN) was decreased in the CIPN group. Parasympathetic tone (high frequency band) were decreased, but sympathetic activity (low frequency band/high frequency band) were increased in CIPN. Conclusions: CIPN affected the quality of life in gastrointestinal cancer patients underwent chemotherapy. HRV was related to CIPN. Further study may be needed to check the feasibility of HRV as early biomarkers for detecting CIPN. [Table: see text]

Evaluating Acupuncture for the Treatment of Chemotherapy-induced Peripheral Neuropathy: An Integrative Review

2021 ◽  
pp. 019394592199253
Author(s):  
Anna M. Kutcher ◽  
Virginia T. LeBaron
Keyword(s):  
Peripheral Neuropathy ◽  
Web Of Science ◽  
Acupuncture Treatment ◽  
Cochrane Review ◽  
Integrative Review ◽  
Current Evidence ◽  
Inclusion Criteria ◽  
Patients With Cancer ◽  
Keywords Acupuncture

The purpose of this integrative review of the literature is to synthesize the current evidence and identify gaps in knowledge regarding the effectiveness of acupuncture to treat chemotherapy-induced peripheral neuropathy (CIPN). PubMed, CINAHL, Web of Science, and Cochrane Review databases were searched using inclusion criteria: keywords acupuncture, cancer, and peripheral neuropathy, published in English, between 2009 and 2019. Sixteen articles met the inclusion criteria. The literature indicates that acupuncture is generally well tolerated by patients with cancer, and a majority of patients with CIPN reported decreased pain and increased quality of life after receiving acupuncture treatment. A comprehensive understanding of the ability of acupuncture to treat CIPN is limited by variability of acupuncture techniques and inconsistency in measures of evaluation.

scholarly journals Serum Vitamin Levels among Iraqi Cancer Patients Receiving Chemotherapy

2021 ◽  
Vol 9 (B) ◽  
pp. 231-234
Author(s):  
Mohammed Salim Abdulrahman ◽  
Hedef D. El-Yassin ◽  
Nada. A. S. Al-Alwan
Keyword(s):  
Cancer Patients ◽  
Performance Status ◽  
Serum Vitamin ◽  
Chemotherapeutic Agents ◽  
Term Outcome ◽  
Nutritional Elements ◽  
Patients With Cancer ◽  
Elisa Technique

BACKGROUND: Cancers are an abnormal irregular growth of cells. There is an interaction between cancer cells, immune cells, and neurotransmitters with nutritional elements and vitamins. With the administration of chemotherapeutic agents, many studies have highlighted the importance of these interactions and the role of chemotherapeutic drugs in augmenting or ameliorating such changes. Therefore, early detection of vitamins level changes is vital to improve patients’ short-term outcome and quality of life. AIM: The aim was assessment of serum vitamins level changes in patients with cancer pre- and post-chemotherapy. MATERIALS AND METHODS: A cohort study was carried out on newly diagnosed patients with cancer in Al-Amal National Radiation Oncology Hospital/Baghdad/Iraq during the period from January 2019 to July 2019. Assessments of the studied samples were conducted as a baseline before receiving chemotherapy and after the third cycle of chemotherapy. Weight, height and body mass index (BMI) were measured for each subject enrolled in the study. Serum level of the following vitamins: A, B1, B2, B3, B6, B12, folic acid, D, and E was measured using ELISA technique. RESULTS: One Hundred patients who were diagnosed with different types of cancer were enrolled in this study. Seventy seven (77%) females and twenty three (23%) males. Mean age was 50.15 years ranged between (18-75) years old, BMI range (16-42). Serum vitamin levels that have shown a significant decrease post chemotherapy as compared with baseline were: A (0.64 ± 0.23 vs 0.64 ± 0.23, P=0.0003), E (19.47 ± 4.714 vs 14.70 ± 5.354, P<0.0001), B12 (366.0 ± 95.94 vs 291.1 ± 102.6, P<0.001), B9 (16.13 ± 4.13 vs 16.13 ± 4.13, P<0.0001) whereas vitamins B6 and D which showed lower than normal baseline level underwent significant increase after chemotherapy yet remained below normal (vitamin B6 4.19 ± 1.94 vs 8.22 ± 5.39; vitamin D 21.11 ± 7.21 vs 26.55 ± 15.22). CONCLUSION: Our findings highlight the importance of updating and tailoring our regimens to suit the changes of the nutritional elements and parameters of performance status of cancer patients in terms of outcome and patient satisfaction.

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