目的评价和总结化疗所致周围神经病变评估和管理的最佳证据。方法计算机检索中国期刊全文数据库、万方数据库、中国生物医学文献数据库、Up To Date、BMJ best practice、Web of Science、Cochrane Library、JBI OVID、PubMed、国际指...目的评价和总结化疗所致周围神经病变评估和管理的最佳证据。方法计算机检索中国期刊全文数据库、万方数据库、中国生物医学文献数据库、Up To Date、BMJ best practice、Web of Science、Cochrane Library、JBI OVID、PubMed、国际指南协作网(GIN)、英国国家卫生与临床优化研究所指南网(NICE)、安大略注册护士协会(RNAO)、美国国家综合癌症网(NCCN)、苏格兰院际指南网(SIGN)等国内外数据库,检索数据库中建库至2020年7月29日该研究领域的所有化疗所致周围神经病变(chemotherapy-induced peripheral neuropathy,CIPN)相关文献,汇总有关CIPN评估和管理的证据。结果共纳入9篇文献,其中指南1篇,证据总结1篇,系统评价4篇,临床决策1篇,实践推荐1篇、专家共识1篇。共汇总24条最佳证据,包括评估与计划、多学科合作、健康教育、非药物管理、药物管理5个维。结论护理人员应从循证的角度对化疗所致周围神经毒性进行评估和管理,根据证据的不断更新,汇总最佳证据,提升护理质量。展开更多
Cancer is a global health problem that is often successfully addressed by therapy, with cancer survivors increasing in numbers and living longer world around. Although new cancer treatment options are continuously exp...Cancer is a global health problem that is often successfully addressed by therapy, with cancer survivors increasing in numbers and living longer world around. Although new cancer treatment options are continuously explored, platinum based chemotherapy agents remain in use due to their efficiency and availability. Unfortunately, all cancer therapies affect normal tissues as well as cancer, and more than 40 specific side effects of platinum based drugs documented so far decrease the quality of life of cancer survivors. Chemotherapy-induced peripheral neuropathy is a frequent side effects of platinum-based chemotherapy agents. This cluster of complications is often so debilitating that patients occasionally have to discontinue the therapy. Sensory neurons of dorsal root ganglia are at the core of chemotherapy-induced peripheral neuropathy symptoms. In these postmitotic cells, DNA damage caused by platinum chemotherapy interferes with normal functioning. Accumulation of DNA-platinum adducts correlates with neurotoxic severity and development of sensation of pain. While biochemistry of DNA-platinum adducts is the same in all cell types, molecular mechanisms affected by DNA-platinum adducts are different in cancer cells and non-dividing cells. This review aims to raise awareness about platinum associated chemotherapy-induced peripheral neuropathy as a medical problem that has remained unexplained for decades. We emphasize the complexity of this condition both from clinical and mechanistical point of view and focus on recent findings about chemotherapy-induced peripheral neuropathy in in vitro and in vivo model systems. Finally, we summarize current perspectives about clinical approaches for chemotherapy-induced peripheral neuropathy treatment.展开更多
文摘目的评价和总结化疗所致周围神经病变评估和管理的最佳证据。方法计算机检索中国期刊全文数据库、万方数据库、中国生物医学文献数据库、Up To Date、BMJ best practice、Web of Science、Cochrane Library、JBI OVID、PubMed、国际指南协作网(GIN)、英国国家卫生与临床优化研究所指南网(NICE)、安大略注册护士协会(RNAO)、美国国家综合癌症网(NCCN)、苏格兰院际指南网(SIGN)等国内外数据库,检索数据库中建库至2020年7月29日该研究领域的所有化疗所致周围神经病变(chemotherapy-induced peripheral neuropathy,CIPN)相关文献,汇总有关CIPN评估和管理的证据。结果共纳入9篇文献,其中指南1篇,证据总结1篇,系统评价4篇,临床决策1篇,实践推荐1篇、专家共识1篇。共汇总24条最佳证据,包括评估与计划、多学科合作、健康教育、非药物管理、药物管理5个维。结论护理人员应从循证的角度对化疗所致周围神经毒性进行评估和管理,根据证据的不断更新,汇总最佳证据,提升护理质量。
基金supported by grant from the Ministry of Education,Science and Technological Development,Republic of Serbia(173051)supported by a UICC Yamagiwa-Yoshida Memorial International Cancer Study Grant(YY2/2015/381414)
文摘Cancer is a global health problem that is often successfully addressed by therapy, with cancer survivors increasing in numbers and living longer world around. Although new cancer treatment options are continuously explored, platinum based chemotherapy agents remain in use due to their efficiency and availability. Unfortunately, all cancer therapies affect normal tissues as well as cancer, and more than 40 specific side effects of platinum based drugs documented so far decrease the quality of life of cancer survivors. Chemotherapy-induced peripheral neuropathy is a frequent side effects of platinum-based chemotherapy agents. This cluster of complications is often so debilitating that patients occasionally have to discontinue the therapy. Sensory neurons of dorsal root ganglia are at the core of chemotherapy-induced peripheral neuropathy symptoms. In these postmitotic cells, DNA damage caused by platinum chemotherapy interferes with normal functioning. Accumulation of DNA-platinum adducts correlates with neurotoxic severity and development of sensation of pain. While biochemistry of DNA-platinum adducts is the same in all cell types, molecular mechanisms affected by DNA-platinum adducts are different in cancer cells and non-dividing cells. This review aims to raise awareness about platinum associated chemotherapy-induced peripheral neuropathy as a medical problem that has remained unexplained for decades. We emphasize the complexity of this condition both from clinical and mechanistical point of view and focus on recent findings about chemotherapy-induced peripheral neuropathy in in vitro and in vivo model systems. Finally, we summarize current perspectives about clinical approaches for chemotherapy-induced peripheral neuropathy treatment.
