Recent Updates on Chemotherapy-Induced Peripheral Neuropathy

Abstract

Chemotherapy induced peripheral neuropathy (CIPN) could debilitate the quality of life in the patients with cancer. According tothe severity of CIPN, the modification of dosage of chemotherapeutic agents and switch to other drugs can be unavoidable. Platinum such as cisplatin and oxalipatin, vinka alkaloids, bortezomib, and taxane can cause CIPN. The characteristics and severityof CIPN depends on the dosages, duration of exposure of chemotherapeutic agents, comcomittant illness or other drugs affecting onperipheral nervous system and the methods of assessment for CIPN. The symptoms may last for several months or permanentlyeven after quitting chemotherapy. Typically it distributed bilaterally and starts from the distal part of extremities and is presentedprogressively in stocking and glove pattern. Sensory nerve is more involved rather than motor nerve and amplitude of sensorynerve conduction is observed in CIPN. Prevention for CIPN is not effective at present. Tricyclic antidepressant including amitriptylineor nortriptyline and gabapentine have been tried in the practice for the management of CIPN despite of the lack of significantevidence through clinical trials. Recently duloxetine has been reported to decrease pain in the patients with CIPN compared with thepatients with placebo (p = 0.03).