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Chemotherapy-induced peripheral neuropathy
Background
Overview
Definition
CIPN is a common complication of chemotherapy, that is predominantly characterized by sensory neuropathy and may be accompanied by motor and autonomic changes.
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Pathophysiology
CIPN can occur in patients with platinum-based antineoplastic agents (oxaliplatin, cisplatin, carboplatin), epothilones (ixabepilone), taxanes (paclitaxel, docetaxel), immunomodulatory drugs (thalidomide), vinca alkaloids (vincristine, vinblastine, vinorelbine, vindesine), and proteasome inhibitors (bortezomib).
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Disease course
CIPN may affect sensory, motor, and/or autonomic functions to varying degrees. Symptoms include numbness, tingling, altered touch sensation, impaired vibration, paresthesias, dysesthesias, spontaneous burning, shooting or electric shock-like pain, allodynia, hyperalgesia, distal weakness, gait and balance disturbances, impaired movements, orthostatic hypotension, constipation, and altered sexual/urinary function. Disease progression may lead to loss of sensation, paresis, complete patient immobilization, severe disability, and reduced QoL.
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Prognosis and risk of recurrence
CIPN is not independently associated with increased mortality.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of chemotherapy-induced peripheral neuropathy are prepared by our editorial team based on guidelines from the American Society of Clinical Oncology (ASCO 2020), the European Oncology Nursing Society (EONS/EANO/ESMO 2020), and the American Cancer Society (ACS 2013).
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