维生素D缺乏与乳腺癌化疗致周围神经病变的相关性研究进展

Research advances on the association of vitamin D deficiency with chemotherapy-induced peripheral neuropathy in breast cancer

摘要:

化疗是乳腺癌综合治疗中的重要组成部分，足量、按时完成化疗对改善患者预后具有关键意义。然而，化疗相关不良反应，尤其是化疗致周围神经病变（CIPN），可严重损害患者生活质量，甚至影响治疗依从性，目前尚缺乏公认有效的防治手段。近年来研究发现，维生素D缺乏可能是乳腺癌患者发生CIPN的重要危险因素。多项基础及临床研究提示，维生素D通过参与神经髓鞘形成、轴突修复、炎症调控及抗氧化应激等过程，在CIPN的发生发展中发挥潜在保护作用，补充维生素D有望降低CIPN发生风险并缓解症状。本文对乳腺癌CIPN的发病机制及维生素D缺乏与CIPN之间的相关性研究进展进行综述，并对维生素D补充的潜在临床价值与未来研究方向进行展望，以期为乳腺癌CIPN的预防与干预提供新的思路。

Abstract:

Chemotherapy is a cornerstone of comprehensive treatment for breast cancer, and the administration of adequate doses on schedule is crucial for improving patient outcomes. However, chemotherapy-related adverse effects, particularly chemotherapy-induced peripheral neuropathy (CIPN), can substantially impair quality of life and compromise treatment adherence, while effective preventive or therapeutic strategies remain limited. Growing evidence indicates that vitamin D deficiency may represent an important risk factor for the development of CIPN in breast cancer patients. Experimental and clinical studies suggest that vitamin D may exert neuroprotective effects by promoting myelination, facilitating axonal regeneration, modulating inflammatory responses, and alleviating oxidative stress, thereby potentially reducing the incidence and severity of CIPN. This review summarizes current advances in the pathophysiological mechanisms of CIPN and the association between vitamin D deficiency and CIPN in breast cancer, and discusses the potential clinical implications of vitamin D supplementation, aiming to provide new insights into the prevention and management of CIPN.