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Manejo del dolor neuropático localizado en el paciente oncológico
Resumen
Introducción: La neuropatía localizada inducida por quimioterapia (NLIQ) es una complicación frecuente y discapacitante en pacientes oncológicos, afectando significativamente su calidad de vida y continuidad terapéutica. Objetivo: Evaluar de manera crítica y sistemática la efectividad y seguridad de las estrategias terapéuticas empleadas en el manejo del dolor neuropático inducido por quimioterapia en adultos con cáncer. Métodos: Revisión sistemática según los lineamientos PRISMA. Se analizaron 40 estudios publicados entre 2014 y 2024, extraídos de bases de datos de alto impacto. Se incluyeron investigaciones con enfoques farmacológicos y no farmacológicos, evaluando eficacia, seguridad y calidad de vida. Resultados: La mayoría de estudios se centraron en cáncer de mama, gastrointestinal y ginecológico. Las estrategias no farmacológicas, como ejercicio físico, fisioterapia y acupuntura, mostraron beneficios consistentes en el control sintomático. Duloxetina fue el fármaco más efectivo, mientras que gabapentinoides y cannabinoides tuvieron eficacia variable y preocupaciones de seguridad. La reducción de dosis de quimioterapia sigue siendo la principal medida de manejo clínico. Discusión: Los hallazgos reflejan una tendencia hacia tratamientos no invasivos y personalizados. Sin embargo, la falta de estandarización metodológica limita la generalización de los resultados y subraya la necesidad de estudios más robustos. Conclusión: No existe un consenso terapéutico unificado para la NLIQ. Un enfoque individualizado y multidisciplinario parece ser el más prometedor. Aporte de la investigación: El estudio proporciona una base de evidencia actualizada que guía la toma de decisiones clínicas y destaca áreas prioritarias para futuras investigaciones en NLIQ.
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DOI: https://doi.org/10.23857/pc.v10i5.9590
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