奥沙利铂基于化疗是结直肠癌（CRC）的标准治疗方法。然而，奥沙利铂引起的外周神经毒性（OIPN）是一种严重的剂量限制性临床问题，可能导致治疗中断。这种神经病可能在停药后可逆转。其复杂的机制与DNA损伤、电压门控离子通道功能障碍、神经炎症、转运体、氧化应激和线粒体功能障碍等有关。已经提出了几种策略，可以减轻OIPN而不影响辅助治疗的疗效，即与化疗保护剂的联合（如谷胱甘肽、Ca / Mg、艾布地拉斯特、度洛西汀等）、时间控制输注、剂量减少、重新使用奥沙利铂和局部给药【肝动脉灌注化疗（HAIC）、压力腹腔喷雾化疗（PIPAC）和热瘤腹腔化疗（HIPEC）】。本文提供了与OIPN潜在机制、治疗策略以及奥沙利铂治疗途径的药代动力学在临床试验中的最新进展相关的更新。Copyright © 2023 Cheng, Zhang, Sun, Ran, Zhang, Shen, Yao, Wang, Song and Peng.

Oxaliplatin-based chemotherapy is a standard treatment approach for colorectal cancer (CRC). However, oxaliplatin-induced peripheral neurotoxicity (OIPN) is a severe dose-limiting clinical problem that might lead to treatment interruption. This neuropathy may be reversible after treatment discontinuation. Its complicated mechanisms are related to DNA damage, dysfunction of voltage-gated ion channels, neuroinflammation, transporters, oxidative stress, and mitochondrial dysfunction, etc. Several strategies have been proposed to diminish OIPN without compromising the efficacy of adjuvant therapy, namely, combination with chemoprotectants (such as glutathione, Ca/Mg, ibudilast, duloxetine, etc.), chronomodulated infusion, dose reduction, reintroduction of oxaliplatin and topical administration [hepatic arterial infusion chemotherapy (HAIC), pressurized intraperitoneal aerosol chemotherapy (PIPAC), and hyperthermic intraperitoneal chemotherapy (HIPEC)]. This article provides recent updates related to the potential mechanisms, therapeutic strategies in treatment of OIPN, and pharmacokinetics of several methods of oxaliplatin administration in clinical trials.Copyright © 2023 Cheng, Zhang, Sun, Ran, Zhang, Shen, Yao, Wang, Song and Peng.