Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process

Abstract

Background: Most individuals affected by cancer who are treated with certain chemotherapies suffer of CIPN. Therefore, there is a high patient and provider interest in complementary non-pharmacological therapies, but its evidence base has not yet been clearly pointed out in the context of CIPN. Methods: The results of a scoping review overviewing the published clinical evidence on the application of complementary therapies for improving the complex CIPN symptomatology are synthesized with the recommendations of an expert consensus process aiming to draw attention to supportive strategies for CIPN. The scoping review, registered at PROSPERO 2020 (CRD 42020165851), followed the PRISMA-ScR and JBI guidelines. Relevant studies published in Pubmed/MEDLINE, PsycINFO, PEDro, Cochrane CENTRAL, and CINAHL between 2000 and 2021 were included. CASP was used to evaluate the methodologic quality of the studies. Results: Seventy-five studies with mixed study quality met the inclusion criteria. Manipulative therapies (including massage, reflexology, therapeutic touch), rhythmical embrocations, movement and mind–body therapies, acupuncture/acupressure, and TENS/Scrambler therapy were the most frequently analyzed in research and may be effective treatment options for CIPN. The expert panel approved 17 supportive interventions, most of them were phytotherapeutic interventions including external applications and cryotherapy, hydrotherapy, and tactile stimulation. More than two-thirds of the consented interventions were rated with moderate to high perceived clinical effectiveness in therapeutic use. Conclusions: The evidence of both the review and the expert panel supports a variety of complementary procedures regarding the supportive treatment of CIPN; however, the application on patients should be individually weighed in each case. Based on this meta-synthesis, interprofessional healthcare teams may open up a dialogue with patients interested in non-pharmacological treatment options to tailor complementary counselling and treatments to their needs.

Exploring Cancer Patients’ Perspectives on Chemotherapy-Induced Peripheral Neuropathy (CIPN) Experiences and Its Management: A Qualitative Study

“…Patients are open to trying medications that can assist in managing CIPN. Patients who develop CIPN are both younger and older, experience restrictions in their quality-of-life functions, and therefore need effective treatment options [42]. Currently, there are limited options for preventing and curing CIPN, and reducing chemotherapy doses is often linked to the onset of neuropathy symptoms.…”

Integrative Nursing Interventions for Cancer-Related Symptoms in Oncology Inpatients: Results of a Descriptive Pilot Study

“…The basis for offering the IN interventions was the IN catalog, which targets relevant cancer-related symptoms and is presented in Table 1 . The IN catalog was developed using a combination of experiential knowledge, relevant literature, 9 , 15 , 20 - 22 and existing recommendations from previous projects. 11 , 23 The catalog underwent continuous revision and further development by the project working group to ensure its effectiveness and relevance.…”

“… 18 Clinical guidelines have already been developed based on reviews and consensus processes, such as those for mucositis, 19 pain 20 and chemotherapy-induced peripheral neuropathy. 21 …”

Leitliniengerechte Tumortherapie ergänzt um komplementäre Verfahren

“…Wir empfehlen spezielle Bewegungsübungen (z. B. Igelball, Vibrationstraining 4 , 5 ), Leinsamenbad, Vorstellung in der Sport- und Rehabilitationsmedizin, rhythmische Einreibungen nach Wegman/Hauschka mit Aconit Schmerzöl an den Füßen 6 , 7 und ernährungsbezogen mind. 2 × /Woche Fisch, wahlweise die Einnahme von Omega-3-Ölen oder -Kapseln (z.…”