Chemotherapy-induced neurotoxicity: the value of neuroprotective strategies

Neth J Med. 2012 Jan;70(1):18-25.


Chemotherapy-induced peripheral neuropathy (CIPN) is a common major dose-limiting side effect of many chemotherapeutic agents, including platinum compounds, taxanes, vinca alkaloids, thalidomide and newer agents such as bortezomib. The incidence and degree of neuropathy depends on the type of cytotoxic drug, the duration of administration, cumulative dose and pre-existing peripheral neuropathy. Because of increasing survival rates of patients treated with neurotoxic agents, CIPN is accompanied by a significant decrease in the patient's quality of life among cancer survivors. Therefore, several neuroprotective strategies, including calcium/magnesium infusion, amifostine, gluthatione, glutamine, acetyl-L-carnitine and erythropoietin as most promising, have been investigated to decrease the neurotoxicity without compromising anti-tumour efficacy. However, clinical evidence for the efficacy of these drugs is sparse. In this review we will give an outline of the neurotoxic effects of chemotherapeutic agents, their clinical manifestations and potential neuroprotective strategies.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Humans
  • Magnesium / therapeutic use
  • Neuroprotective Agents / therapeutic use*
  • Neurotoxicity Syndromes / drug therapy
  • Neurotoxicity Syndromes / etiology*
  • Radiation-Protective Agents / therapeutic use
  • Risk Factors
  • Vitamin E / therapeutic use


  • Antineoplastic Agents
  • Neuroprotective Agents
  • Radiation-Protective Agents
  • Vitamin E
  • Magnesium