Opioids in the treatment of chemotherapy-induced polyneuropathy

Chemotherapy-induced polyneuropathy (CIPN) is a frequent complication of causative therapy for cancer. The frequency of occurrence of this phenomenon implies the necessity to consider all the possible methods of treatment. The main medications are antiepileptic drugs and antidepressants; however, opioids constitute an integral part of a complex therapy in this nosological unit. The presented report is an attempt to evaluate the current knowledge concerning the role of opioids in the treatment of CIPN.

Due to the lack of studies concerning the application of opioids in CIPN, conclusions concerning their effectiveness may be drawn only by analogy. Based on the literature available concerning model experiments and clinical observations, it may be presumed that opioids are important components of complex therapy in the case of neuropathic pain; thus they are also efficient during the treatment of chemotherapy-induced polyneuropathy. Affinity to membrane receptors is among the preconditions of the analgesic effect of opioid drugs. The variety of these proteins and their sub-classes determines the various effectiveness of their ligands, which justifies both opioid rotation and binding. Based on model studies and clinical observations, it was noted that from among pure opioid receptor agonists, oxycodone showed the strongest analgesic activity in neuropathic pain.