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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Print: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.2013010265
pages 261-274

Chemotherapy-Induced Peripheral Neurotoxicity: Approach to Rehabilitation

Leonardo Sanches Municelli
Institute of Physical Medicine and Rehabilitation, Rehabilitation Department, Cancer Institute of Sao Paulo, Sao Paulo School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
Rebeca Boltes Cecatto
Rehabilitation Department of the Cancer Institute of Sao Paulo, Sao Paulo School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
Christina May Moran de Brito
Sirio-Libanes Hospital, Rehabilitation Service, Cancer Institute of Sao Paulo, Sao Paulo, Brazil
Linamara Rizzo Battistella
Sao Paulo School of Medicine, University of Sao Paulo, Sao Paulo, Brazil

ABSTRACT

This review focuses on peripheral neuropathy (PN) induced by chemotherapeutic agents in the context of clinical symptoms, neuroprotection strategies, pharmacological treatment, risk factors, and rehabilitation. This critical review was drawn from an examination of MEDLINE and from 54 selected articles based on relevance, importance, number of patients, and accuracy of reporting of chemotherapy-induced PN (CIPN). CIPN is predominantly sensory axonal neuropathy and is related to the cumulative dose of chemotherapy in most patients. Because of the higher risk of PN developing in patients with pre-existing neuropathy, a surveillance model of treatment and prevention is important in identifying patients with pre-existing PN disorders. Early detection and timely intervention are paramount in maintaining patient safety. Several drugs have been investigated for neuroprotection from and treatment of PN. There are data suggesting the use of calcium/magnesium infusion in oxaliplatin-induced neuropathy and CIPN treatment with venlafaxine and acetyl-L-carnitine. In limited studies, acupuncture has been shown to be a beneficial treatment for CIPN. There are no studies that show a benefit of exercise in CIPN, but there is some evidence that resistance exercises as well as balance and gait training are beneficial. Rehabilitation may be necessary to limit the amount of damage associated with neurotoxic chemotherapy and to minimize dysfunction, impairment, and disability.


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