Anthracyclines, a class of drugs considered as most effective anticancer drugs, used in the various regimens of cancer chemotherapy, induce long-term impairment of mitochondrial respiration, increase reactive oxygen species, and induce other mechanisms potentially leading to neurotoxicity. According to literature findings, one drug of this class - doxorubicin used to treat e.g. breast cancer, bladder cancer, lymphoma, and acute lymphocytic leukemia may induce such effects in the nervous system. Doxorubicin has poor penetration into the brain due to the lack of drug penetration through the blood-brain barrier, thus the toxicity of this agent is the result of its peripheral action. This action is manifested by cognitive impairment and anatomical changes in the brain and peripheral nervous system found in both preclinical and clinical studies in adult patients. Furthermore, more than 50% of children with cancer are treated with anthracyclines including doxorubicin, which may affect their nervous system, and lead to lifelong damage in many areas of their life. Despite ongoing research into the side effects of this drug, the mechanism of its neurotoxicity action on the central and peripheral nervous system is still not well understood. This review aims to summarize the neurotoxic effects of doxorubicin in preclinical (in vitro and in vivo) research and in clinical studies. Furthermore, it discusses the possible mechanisms of the toxic action of this agent on the nervous system.

蒽环类药物被认为是最有效的抗癌药物，用于各种癌症化疗方案，会引起线粒体呼吸的长期损害，增加活性氧，并诱发其他可能导致神经毒性的机制。根据文献发现，此类药物中的一种——用于治疗乳腺癌、膀胱癌、淋巴瘤和急性淋巴细胞白血病的阿霉素可能会在神经系统中引起这种作用。由于阿霉素不能透过血脑屏障，因此对大脑的渗透性较差，因此该药物的毒性是其外周作用的结果。在成年患者的临床前和临床研究中发现，这种作用表现为认知障碍以及大脑和周围神经系统的解剖学变化。此外，超过 50% 的癌症儿童接受包括阿霉素在内的蒽环类药物治疗，这可能会影响他们的神经系统，并导致他们生活的许多方面受到终生损害。尽管对该药物的副作用正在进行研究，但其对中枢和周围神经系统的神经毒性作用机制仍不清楚。本综述旨在总结阿霉素在临床前（体外和体内）研究和临床研究中的神经毒性作用。此外，它还讨论了该药物对神经系统的毒性作用的可能机制。