Rehabilitation, exercise, and related non-pharmacological interventions for chemotherapy-induced peripheral neurotoxicity: Systematic review and evidence-based recommendations

Crit Rev Oncol Hematol. 2022 Mar:171:103575. doi: 10.1016/j.critrevonc.2021.103575. Epub 2021 Dec 28.

Abstract

Pharmacological strategies for chemotherapy-induced peripheral neurotoxicity (CIPN) are very limited. We systematically reviewed data on rehabilitation, exercise, physical therapy, and other physical non-pharmacological interventions and offered evidence-based recommendations for the prevention and treatment of CIPN. A literature search using PubMed, Web of Science and CINAHL was conducted from database inception until May 31st, 2021. 2791 records were title-abstract screened, 71 papers were full-text screened, 41 studies were included, 21 on prevention and 20 on treatment of CIPN. Treatment type, cancer type, chemotherapy compounds were heterogeneous, sample size was small (median: N = 34) and intention-to-treat analysis was lacking in 26/41 reports. Because of the methodological issues of included studies, the reviewed evidence should be considered as preliminary. Exercise, endurance, strength, balance, and sensorimotor training have been studied in low-to-moderate quality studies, while the evidence for other treatments is preliminary/inconclusive. We offer recommendation for the design of future trials on CIPN.

Keywords: Chemotherapy-induced peripheral neurotoxicity (CIPN); Evidence-based medicine; Exercise; Physical therapy; Rehabilitation; Treatment.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Exercise
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / drug therapy
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / therapy

Substances

  • Antineoplastic Agents