J Korean Acad Nurs.  2018 Apr;48(2):123-142. 10.4040/jkan.2018.48.2.123.

Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis

• Oh PJ
• Kim YL

• KMID: 2410647
• DOI: http://doi.org/10.4040/jkan.2018.48.2.123

Abstract

PURPOSE
This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN).
METHODS
PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses.
RESULTS
Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=+0.71) and CIPN pain (d=+0.73) (p < .001). Massage and foot bath were also effective in reducing CIPN symptoms (d=+0.68; 95% CI=+1.05, +0.30; p < .001; I2=19%).Exercises were effective in improving muscle strength and endurance(d=+0.55) and quality of life (d=+2.96), but they were not significantly effective in improving CIPN.
CONCLUSION
Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

Keyword

Chemotherapy, Adjuvant; Meta-analysis; Peripheral Nervous System Diseases

MeSH Terms

Acupuncture
Baths
Bias (Epidemiology)
Chemotherapy, Adjuvant
Drug Therapy*
Foot
Humans
Massage
Muscle Strength
Peripheral Nervous System Diseases*
Quality of Life

Figure

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  Figure 1. Flow diagram of study screening.

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  Figure 2. Forest plots of the effect of non-pharmacologic intervention.

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  Figure 3. Funnel plots of standard error by standardized mean difference.

Reference

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