Chemotherapy associated central nervous system damage

Abstract

Chemotherapy is commonly associated with harmful effects to multiple organ systems, including the central nervous system (CNS). Neurotoxicity may manifest as both acute and delayed complications, which is particularly a concern for long-term survivors. Patients may experience a wide range of neurotoxic syndromes, ranging from neuro-vascular complications and focal neurological deficits to generalized neurological decline with cognitive impairment, cortical atrophy and white matter abnormalities. Along with the use of more aggressive and combined treatment modalities and prolonged survival of cancer patients, neurological complications have been observed with increasing frequency. The mechanisms by which cancer therapy, including chemotherapy and radiation, result in neurological complications, have been poorly understood. Recent studies have now started to unravel the cell-biological basis for commonly seen neurotoxic syndromes and have provided compelling explanations for delayed neurological complications, such as cognitive decline, progressive myelin disruption and brain atrophy.