Neurological complications of cancer chemotherapy

Purpose of review To update central and peripheral nervous system j neurological manifestations caused by anticancer agents. Recent findings Mostly unpredictable encephalopathy continues to be sporadically reported even in patients treated systemically with conventional chemotherapy doses. Recently, capecitabine, a 5-fluorouracil prodrug, has been added to the list. Magnetic resonance diffusion-weighted and fluid; attenuated inversion-recovery imaging are useful in 1 demonstrating chemotherapy-induced central nervous system lesions. The pathogenesis of these lesions is often poorly understood, and is probably multifactorial. A recent observation indicates that genetic polymorphism for methionine is a potent risk factor for methtrexate-induced central nervous system toxicity. Chronic peripheral neuropathy still represents a major limiting factor in a series ! of chemotherapeutic drugs, and the neuroprotective effect of several older and newer agents is either deceptive or insufficiently proven. In addition to chronic neuropathy, oxaliplatine causes a unique acute syndrome which may respond to calcium plus magnesium infusion. Summary Neurotoxicity remains a major limitation of many drugs used in cancer patients. Their list grows steadily, and magnetic i resonance imaging makes easier the recognition of central a nervous system toxicity. Synthesis and thorough clinical j testing of-neuroprotective molecules remain a major 1 j challenge.