Evidence-Based Treatment of Pain in Chemotherapy-Induced Peripheral Neuropathy

Purpose of Review Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and often painful condition that occurs after administration of chemotherapeutic agents. The primary objective of this systematic review was to appraise the literature on conservative, pharmacological, and interven...

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Bibliographic Details
Published in:Current pain and headache reports 2023-05, Vol.27 (5), p.99-116
Main Authors: D’Souza, Ryan S., Alvarez, Gabriel A. Martinez, Dombovy-Johnson, Marissa, Eller, Jennifer, Abd-Elsayed, Alaa
Format: Article
Language:English
Subjects:
Antineoplastic Agents - adverse effects
Chemotherapy
Humans
Internal Medicine
Medicine
Medicine & Public Health
Neoplasms - chemically induced
Neoplasms - drug therapy
Neuralgia - drug therapy
Neuralgia - therapy
Neuropathic Pain (A Abd-Elsayed
Observational Studies as Topic
Pain Management
Pain Medicine
Peripheral neuropathy
Section Editor
Systematic review
Topical Collection on Neuropathic Pain
Transcutaneous Electric Nerve Stimulation
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Summary:Purpose of Review Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and often painful condition that occurs after administration of chemotherapeutic agents. The primary objective of this systematic review was to appraise the literature on conservative, pharmacological, and interventional treatment options for CIPN pain. Recent Findings There is level I evidence supporting modest to moderate improvement in CIPN pain from duloxetine treatment, as well as short-term modest improvement from physical therapy and acupuncture. Although opioid and cannabis administration may provide short-term modest improvement, administration is commonly limited by side effects. Generally, most studies reported no clinical benefit from yoga, topical neuropathic agents, gabapentinoids, and tricyclic antidepressants. Evidence is currently equivocal for scrambler therapy and transcutaneous electrical nerve stimulation. Finally, evidence on neuromodulation options is limited to mostly case reports/series and one observational study highlighting moderate improvement with auricular nerve stimulation. Summary This systematic review provides an overview of conservative, pharmacologic, and interventional treatment modalities for CIPN pain. Furthermore, it provides a level of evidence and degree of recommendation based on the United States Preventive Services Task Force (USPSTF) criteria for each specific treatment modality.
ISSN:1531-3433
1534-3081
DOI:10.1007/s11916-023-01107-4