Neuropatía inducida por quimioterapia en la práctica clínica

Abstract

Neuropathic pain is a common symptom amongst patients with chemotherapy induced peripheral nerve neurotoxicity, and symptoms are indistinguishable from those seen with toxic neuropathy from other causes. The neuropathy is predominantly sensory and follows a glove-stocking distribution and associates with burning pain. Autonomic neuropathy manifested as constipation frequently occurs. There are some risk factors for neuropathy caused by chemotherapy: patients with asymptomatic hereditary neuropathies can become symptomatic after the administration of chemotherapy, others comorbidities like diabetes are also important. Within a drug family there are some agents that are more likely to cause neuropathy than others; among platinum agents, CDDP and oxaliplatin are the most neurotoxic; in the case of CDDP associated neuropathy, the incidence doubles when the cumulative dose exceeds 300 mg/m2. The simultaneous administration of two or more neurotoxic agents increases the risk and severity of neuropathy related symptoms.

Management of chemotherapy induced neuropathy included diverse strategies such: dose reduction and neuroprotection with different gents, like E vitamin and glutamine. Pain management takes place with usual drugs and physical and occupational therapy.