Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of clinical studies
PubMed 25261162 · doi:10.1016/j.pain.2014.09.020
What was done
Systematic review and random-effects meta-regression adhering to PRISMA guidelines to assess the prevalence, course, and risk factors of chemotherapy-induced peripheral neuropathy (CIPN). Authors searched Embase, Medline, CAB Abstracts, CINAHL, PubMed Central, Cochrane Library, and Web of Knowledge, evaluating study quality using CONSORT and STROBE guidelines across 31 studies comprising 4,179 patients.
What was found
CIPN prevalence was 68.1% (95% CI: 57.7–78.4%) at 1 month post-chemotherapy, 60.0% (95% CI: 36.4–81.6%) at 3 months, and 30.0% (95% CI: 6.4–53.5%) at 6 months or more. Prevalence varied by chemotherapy agent. Clinical risk factors identified across four studies included baseline neuropathy, smoking, abnormal creatinine clearance, and specific sensory changes during chemotherapy; four studies reported genetic risk factors.
Why it matters
It establishes quantitative prevalence estimates showing that roughly one-third of cancer patients develop chronic CIPN lasting at least six months, demonstrating the clinical need for routine long-term surveillance.
Limits
The findings were limited by evident publication bias, wide confidence intervals (particularly for long-term estimates at ≥6 months), variation across chemotherapy regimens, and sparse reporting of risk factors (only four studies evaluated clinical or genetic predictors).
Cited by
- supports Up to one-third of chemotherapy patients develop damage to their peripheral nerves.
- context For certain chemotherapeutic agents, 80% to 90% of patients are expected to develop peripheral neuropathy.