Neurological Complications of Chemotherapy


Introduction

Chemotherapy-related neurotoxicity is a frequently observed side effect that has become more prevalent with the increasing number of long-term cancer survivors. These toxicities can be peripheral or central and can range from minor cognitive issues to encephalopathy or dementia. Toxicities are often dose-limiting, resulting in dose reduction or treatment discontinuation, potentially compromising the therapeutic efficacy. This chapter will discuss the incidence, mechanism, symptoms, and management of chemotherapy-related neurotoxicity with a focus on the more common chemotherapeutic agents. The Common Terminology Criteria for Adverse Events (CTCAE) is widely used in the evaluation of chemotherapy-induced peripheral neuropathy. ( Table 7.1 ) Fig. 7.1 illustrates an algorithm for the evaluation and treatment of chemotherapy-related peripheral neuropathy.

TABLE 7.1
Common Terminology Criteria for Adverse Events (CTCAE) Chemotherapy-Induced Peripheral Neuropathy
Grade Definition
1 Asymptomatic; clinical or diagnostic observations only
2 Moderate symptoms; limiting instrumental ADL
3 Severe symptoms; limiting self-care ADL
4 Life-threatening consequences; urgent intervention indicated
ADL , Activities of daily living.

Fig. 7.1, Treatment algorithm for peripheral neuropathy. 2 3 4 5

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