Molekulyarnaya Meditsina (Molecular medicine)Molekulyarnaya Meditsina (Molecular medicine)Молекулярная медицина1728-29182499-9490Russkiy Vrach Publishing House68916910.29296/24999490-2025-04-09ReviewsОбзорыResearch ArticleNeurotoxic complications of cancer chemotherapyНейротоксические осложнения химиотерапии онкологических заболеванийhttps://orcid.org/0000-0003-0665-7428EvertLydia SemenovnaЭвертЛидия Семеновна
Russian Federation

Chief Researcher, Clinical Department of Somatic and Mental Health of Children, a separate unit – Research Institute of Medical Problems of the North, Professor of the Department of General Professional Disciplines, Medical Institute, Doctor of Medical Sciences

главный научный сотрудник клинического отделения соматического и психического здоровья детей, обособленное подразделение – НИИ медицинских проблем Севера, профессор кафедры общепрофессиональных дисциплин, Медицинский институт, доктор медицинских наук

lidiya_evert@mail.ruhttps://orcid.org/0000-0003-1133-4447PotupchikTatyana VitalievnaПотупчикТатьяна Витальевна
Russian Federation

Associate Professor, Department of Pharmacology and Clinical Pharmacology with a postgraduate course, Candidate of Medical Sciences

доцент кафедры фармакологии и клинической фармакологии с курсом постдипломного образования

potupchik_tatyana@mail.ruhttps://orcid.org/0000-0002-2697-7317SaranchinaYulia VladimirovnaСаранчинаЮлия Владимировна
Russian Federation

Associate Professor of the Department of Fundamental Medicine, Medical Institute, Candidate of Biological Sciences

доцент кафедры фундаментальной медицины, Медицинский институт, кандидат биологических наук

july.saran4ina2010@yandex.ruhttps://orcid.org/0009-0004-4207-016XKhadzievaMadina KureishevnaХадзиеваМадина Курейшевна
Russian Federation

5thyear student

студентка 5 курса

beki.gi@bk.ruhttps://orcid.org/0009-0004-0819-4206SamoyavchevaVarvara SergeevnaСамоявчеваВарвара Сергеевна
Russian Federation

5thyear student

студентка 5 курса

samoyavvarvara@gmail.comhttps://orcid.org/0009-0007-4005-2322TsalikovaRufina Ramil’evnaЦаликоваРуфина Рамильевна
Russian Federation

5thyear student

студентка 5 курса

traffic88@list.ruFederal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences»ФИЦ «Красноярский научный центр Сибирского отделения Российской академии наук»Khakass State University named after N.F. Katanov of the Ministry of Science and Higher Education of the Russian FederationХакасский государственный университет имени Н.Ф. Катанова Министерства науки и высшего образования РФFederal State Budgetary Educational Institution of Higher Education «Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky» of the Ministry of Health of the Russian FederationФГБОУ ВО «Красноярский государственный медицинский университет им. профессора В.Ф. Войно-Ясенецкого» Министерства здравоохранения Российской ФедерацииFederal State Autonomous Educational Institution of Higher Education «N.I. Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Министерства здравоохранения Российской Федерации2708202523456631308202513082025Copyright ©; 2025, Russkiy Vrach Publishing HouseCopyright ©; 2025, ИД "Русский врач"2025Russkiy Vrach Publishing HouseИД "Русский врач"https://journals.eco-vector.com/1728-2918/article/view/689169

Introduction. Neurotoxicity is a common complication of chemotherapy that negatively affects the quality of life of cancer patients. Damage to the nervous system affects both the peripheral nerves (peripheral neuropathy) and the central nervous system (chemo brain), manifesting itself as cognitive impairment.

The main of the review. Аnalysis and generalization of key aspects of chemotherapy neurotoxicity, including pathogenetic mechanisms of damage to the nervous system, characteristics of the most significant neurotoxic drugs and risk factors for these complications.

Material and methods. The review includes studies published between 2005 and 2024. The search for publications was conducted in the PubMed, Scopus, Web of Science, eLibrary, Cochrane Library, Springer, CyberLeninka, Wiley Online Library, Nature, ScienceDirect, Science, Cell, Frontiers databases using the main keywords. A total of 1240 articles were found, 63 sources were used for citation.

Results. The article reviews current data on the incidence of peripheral neuropathy in cancer patients (68%) and its long-term persistence in one third of patients. The main mechanisms of neurotoxicity (mitochondrial damage, impaired axonal transport, cytoskeletal dysfunction, activation of inflammatory and autoimmune reactions) are discussed. The causes of central neurotoxicity (impaired neurogenesis, neuronal DNA damage, glial activation, chronic neuroinflammation, and white matter demyelination) are highlighted. The key groups of neurotoxic drugs (platinum compounds, taxanes, vinca alkaloids, proteasome inhibitors, immunomodulators) and significant risk factors for neurotoxicity (old age, underlying neuropathy, diabetes mellitus, nutritional deficiency, chronic diseases, and genetic predisposition) are highlighted.

Conclusion. Despite progress in understanding the pathogenesis, effective methods for preventing and treating neurotoxic complications are limited, and reliable prognostic biomarkers have not been identified. Further interdisciplinary research into the mechanisms of nervous system damage and the development of personalized patient management strategies that optimize the effectiveness of antitumor therapy while minimizing neurological complications are needed.

Введение. Нейротоксичность является распространенным осложнением химиотерапии, негативно влияющим на качество жизни пациентов с онкологическими заболеваниями. Повреждение нервной системы затрагивает как периферические нервы (периферическая нейропатия), так и центральную нервную систему («химический мозг»), проявляясь когнитивными расстройствами.

Цель обзора. анализ и обобщение ключевых аспектов нейротоксичности химиотерапии, включая патогенетические механизмы повреждения нервной системы, характеристику наиболее значимых нейротоксичных лекарственных препаратов и факторы риска данных осложнений.

Материал и методы. Обзор включает исследования, опубликованные в период с 2005 по 2024 гг. Поиск публикаций проведен в базах данных PubMed, Scopus, Web of Science, eLibrary, Cochrane Library, Springer, CyberLeninka, Wiley Online Library, Nature, ScienceDirect, Science, Cell, Frontiers, с использованием основных ключевых слов. Всего найдено 1240 статей, для цитирования использовано 63 источника.

Результаты. Рассмотрены современные сведения о частоте периферической нейропатии у онкологических больных (68%), ее длительном персистировании у трети пациентов. Обсуждаются основные механизмы нейротоксичности (повреждение митохондрий, нарушение аксонального транспорта, дисфункция цитоскелета, активация воспалительных и аутоиммунных реакций). Освещаются причины центральной нейротоксичности (нарушение нейрогенеза, повреждение ДНК нейронов, глиальная активация, хроническое нейровоспаление и демиелинизация белого вещества). Выделены ключевые группы нейротоксичных препаратов (соединения платины, таксаны, винкаалкалоиды, ингибиторы протеасом, иммуномодуляторы) и значимые факторы риска нейротоксичности (пожилой возраст, исходная нейропатия, сахарный диабет, нутритивная недостаточность, хронические заболевания и генетическая предрасположенность).

Заключение. Несмотря на прогресс в понимании патогенеза, эффективные методы профилактики и лечения нейротоксических осложнений ограничены, не выявлено надежных прогностических биомаркеров. Необходимы дальнейшие междисциплинарные исследования механизмов повреждения нервной системы и разработка персонализированных стратегий ведения пациентов, позволяющих оптимизировать эффективность противоопухолевой терапии при минимизации неврологических осложнений.

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