Published online Aug 10, 2017. doi: 10.5306/wjco.v8.i4.329
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
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.
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.