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

  • Neuropathic Pain (A Abd-Elsayed, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

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.

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Data Availability

Data are available upon request to the corresponding author.

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Acknowledgements

We would like to thank Mrs. Cynthia J. Chelf MLS, AHIP for developing the search strategy.

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Authors and Affiliations

  1. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, MN, USA

    Ryan S. D’Souza & Jennifer Eller

  2. Department of Physical Medicine and Rehabilitation, Mayo Clinic Hospital, Rochester, MN, USA

    Gabriel A. Martinez Alvarez & Marissa Dombovy-Johnson

  3. Department of Anesthesiology, University of Wisconsin, Madison, WI, USA

    Alaa Abd-Elsayed

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  1. Ryan S. D’Souza
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  2. Gabriel A. Martinez Alvarez
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  4. Jennifer Eller
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  5. Alaa Abd-Elsayed
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Every author (RSD, MDJ, GAMA, JE, AA) made substantial contributions to the conception and design of the work, drafted and revised the intellectual content, provided final approval of the published version, and are in agreement to be accountable for all aspects of the work related to accuracy and integrity of the work.

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Correspondence to Alaa Abd-Elsayed.

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RSD has an investigator-initiated grant with Nevro Corp and Saol Therapeutics. The other co-authors of this work declare no conflicts of interest.

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D’Souza, R.S., Alvarez, G.A.M., Dombovy-Johnson, M. et al. Evidence-Based Treatment of Pain in Chemotherapy-Induced Peripheral Neuropathy. Curr Pain Headache Rep 27, 99–116 (2023). https://doi.org/10.1007/s11916-023-01107-4

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