Chemotherapy-induced neurotoxicity is becoming increasingly important in the management of patients with cancer. Improvements in other aspects of supportive care has permitted escalation of chemotherapy doses, increasing the risk of neurotoxicity.REVIEW SUMMARY
Many chemotherapeutic agents have associated neurotoxicities. Recognition of these various syndromes is important in distinguishing this cause from other, treatable entities. Furthermore, early recognition of toxicities may enable alteration in delivery or mandate cessation of treatment before severe or life-threatening toxicity occurs. Chemotherapy neurotoxicity can effect both the peripheral and central nervous systems. The onset may be acute or insidious, the effects transient or progressive and permanent. The goals of ongoing investigations are to fully describe the potential neurotoxicities of the treatments, uncover the mechanisms of toxicity, and develop new strategies to reduce or prevent the toxicity, either by altering the chemotherapeutic agent, modifying administration, or developing neuro-protective agents. New chemotherapies, particularly those designed to treat central nervous system malignancy, require close examination of their neurotoxic potential.CONCLUSIONS
Although the diagnosis of chemotherapy-induced neurotoxicity is frequently made by excluding other causes, prompt recognition may be critical in preventing severe, irreparable injury to the nervous system. Advances in understanding the pathogenesis of injury, coupled with increasing knowledge of the mechanisms of neuronal repair, should lead to new treatments to reverse or prevent neuronal injury.