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World J Clin Oncol. Aug 10, 2017; 8(4): 329-335
Published online Aug 10, 2017. doi: 10.5306/wjco.v8.i4.329
Platinum-induced neurotoxicity: A review of possible mechanisms
Ozkan Kanat, Hulya Ertas, Burcu Caner
Ozkan Kanat, Hulya Ertas, Burcu Caner, Department of Medical Oncology, Uludag University Faculty of Medicine, 16059 Bursa, Turkey
Author contributions: Kanat O assigned the issue and performed the majority of the writing, prepared the figure; Ertas H and Caner B both designed the outline and coordinated the writing of the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ozkan Kanat, MD, PhD, Professor, Department of Medical Oncology, Uludag University Faculty of Medicine, Gorukle, 16059 Bursa, Turkey. ozkanat@uludag.edu.tr
Telephone: +90-224-2951321
Received: April 10, 2017
Peer-review started: April 12, 2017
First decision: May 22, 2017
Revised: June 13, 2017
Accepted: June 30, 2017
Article in press: July 3, 2017
Published online: August 10, 2017
Processing time: 119 Days and 4.5 Hours
Abstract

Patients treated with platinum-based chemotherapy frequently experience neurotoxic symptoms, which may lead to premature discontinuation of therapy. Despite discontinuation of platinum drugs, these symptoms can persist over a long period of time. Cisplatin and oxaliplatin, among all platinum drugs, have significant neurotoxic potential. A distal dose-dependent symmetrical sensory neuropathy is the most common presentation of platinum neurotoxicity. DNA damage-induced apoptosis of dorsal root ganglion (DRG) neurons seems to be the principal cause of neurological symptoms. However, DRG injury alone cannot explain some unique symptoms such as cold-aggravated burning pain affecting distal extremities that is observed with oxaliplatin administration. In this article, we briefly reviewed potential mechanisms for the development of platinum drugs-associated neurological manifestations.

Keywords: Cisplatin; Dorsal root ganglion; Mechanism; Oxaliplatin; Neurotoxicity; Neuropathic pain; Sodium channel

Core tip: Platinum drug-based chemotherapies may lead to intolerable neuropathic symptoms, preventing their administration at the optimal effective doses and duration. A better understanding of potential mechanisms underlying these symptoms can help clinicians better manage patients experiencing acute and/or cumulative neurotoxicity during treatment with platinum-containing chemotherapy.