Table 1.
Characteristics of Included Systematic Reviews in the Overview.
| Author(s), year | Databases searched | No. of clinical CIPN studies/no. of patients | Target population | Included clinical study design | Type of chemotherapy | Intervention | Control | Outcomes (outcome measurements) | Risk of bias tool | Funding source |
|---|---|---|---|---|---|---|---|---|---|---|
| Eum et al19 | MEDLINE, EMBASE, CENTRAL the reference lists; NA | 5/319 | Cancer patients receiving chemotherapy | RCTs | Taxanes, cisplatin, carboplatin, oxaliplatin, combination | Oral vitamin E supplements | No treatment or placebo | Incidence of CIPN | The Jadad scale | NR |
| Franconi et al20 | MEDLINE, Google Scholar, Cochrane Database, CINAHL, CNKI, Wanfang Med Online, and ISI conference Proceedings; January 2012 reference lists | 7/265 | NR | RCTs, NRSIs, case series | Not specified | All types of acupuncture (electroacupuncture, auricular acupuncture; warm acupuncture, and moxibustion) | No control, placebo acupuncture and seeds, cobamamide, neurotrophin | VAS pain score, medication consumption, Questionnaire of CIPN/PN, WHO CIPN grade, QoL, neurotoxic symptoms, NCV | Not assessed | NR |
| He and Yang21 | CNKI, Wanfang, VIP; NA | 5/425 | Cancer patients receiving oxaliplatin chemotherapy | Prospective RCTs | Oxaliplatin | External use of Chinese herbal medicine | No treatment (nursing care) | Incidence of CIPN (WHO scale) | The modified Jadad scale | NR |
| Schloss et al22 | PubMed, the Cochrane Library, Science Direct, Scopus, EMBASE, MEDLINE, CINAHL; NA | 23/2075 | Cancer patients who had received or were undergoing chemotherapy | RCTs, NRSIs, case studies | Platinum derivates (oxaliplatin, carboplatin, cisplatin), taxanes (paclitaxel), combination Tx | Nutraceuticals (Magnesium and calcium, vitamin B6, vitamin E, glutathione, glutamine, N-acetyl cysteine, acetyl-l-carnitine, lipoic acid, omega-3 fatty acids, electroacupuncture included) | Placebo, current anti-CIPN treatment, no control | Incidence and/or severity of CIPN (TNS), electro-physiologic evaluation (NCV) | NHMRC clinical evidence assessment matrix | NICM/NHMRC funding; Bioconcepts Ltd Industry funding |
| Tian et al23 | MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, VIP, Wanfang; December 2012 | 6/368 | Cancer patients receiving oxaliplatin chemotherapy | RCTs, quasi-RCTs | Oxaliplatin | Chinese herbal decoction (Huang Qi Gui Zhi Wu Wu decoction) | No treatment (nursing care), conventional therapeutic agents | Incidence and severity of CIPN (Levi scale), SNCV, AE | Cochrane Collaboration’s RoB tool | National Chinese Medicine Industry Research Project of China |
| Streckmann et al24 | PubMed, MEDPILOT (MEDLINE), Cochrane Database, reference lists; December 2013 | 18/837 | Lymphoma participants with CIPN | RCTs, NRSIs | Not specified | Exercise intervention (sensorimotor training, endurance and strength) | Not specified | QoL, peripheral deep sensitivity, incidence and severity of CIPN, balance control, aerobic performance level, level of activity | The Oxford levels of evidence by OCEBM | None |
| Brami et al25 | Web of Science, PubMed, CENTRAL; January 2005 to May 2015 | 13/1370 | Cancer adults diagnosed with CIPN | Prospective RCTs | Platinum derivates (oxaliplatin, carboplatin, cisplatin), taxanes (paclitaxel), vinca alkaloids, combination Tx | Natural products and complementary therapies (vitamin E, glutamate/glutamine, goshajinkigan, acetyl-l-carnitine, alpha-lipoic acid, omega-3 fatty acids, electro-acupuncture) | Not specified (non-supplemented, placebo, usual care alone, hydroelectric baths, vitamin B1/B6) | The incidence of PN (NSS, NDS), neurological exams (TNS), severity score questionnaires (NCI-CTCAEv2.0; EORTC QLQ-C30; NTX-FACT), NCV (SNCV, MNCV) | Not assessed | NR |
| Deng et al26 | MEDLINE (1982-2015), Cochrane Controlled Trials (2015, Issue 12), Springer (1997-2015), CNKI (1997-2015), CSPD (1998-2015), reference lists; January 2016 | 24/1552 | Cancer adults had received or were undergoing oxaliplatin chemotherapy | RCTs | Oxaliplatin | All types of Radix Astragali–based herbal interventions | Placebo, no intervention, conventional treatment | The severity and/or incidence rate of CIPN (WHO, Levi, NCI-CTCAE, DEB-NTC), remission rate (CR + PR), NCV (SNCV, MNCV), QoL | Improved Jadad scale | Beijing Municipal Science & Technology Commission; National Fund of Natural Science of China |
| Deng et al27 | MEDLINE (1982-2015), Cochrane Controlled Trials (2015, Issue 4), CNKI (1997-2015), CSPD (1989-2015), reference lists; May 2015 | 26/1682 | Cancer adults had received or were undergoing oxaliplatin chemotherapy | RCTs | Oxaliplatin | All types of Caulis Spatholobi–based herbal interventions | Placebo, no intervention, conventional treatment | The severity and/or incidence rate of CIPN (WHO, Levi, NCICTCAE, DEB-NTC), remission rate (CR + PR), NCV (SNCV, MNCV), QoL (KPS, ECOG) | Improved Jadad scale | Beijing Municipal Science & Technology Commission; National Fund of Natural Science of China |
| Huang et al28 | MEDLINE, EMBASE, CENTRAL, the reference lists; December 2013 | 6/353 | Cancer patients receiving chemotherapy | RCTs | Oxaliplatin, cisplatin, and other types of chemotherapy | Oral vitamin E supplements | Placebo or conventional treatment | The incidence of CIPN, safety of vitamin E administration | Cochrane Collaboration’s RoB tool | China Mianyang Central Hospital (Funding number: 2014YJ28) |
| Ji29 | MEDLINE, EMBASE, CENTRAL, CBM, CNKI, VIP, Wanfang, relevant journals; October 2015 | 75/2025 | Cancer patients receiving oxaliplatin chemotherapy | RCTs, quasi-RCTs | Oxaliplatin | Chinese herbal medicine | No treatment (nursing care), conventional therapeutic agents | Incidence and severity of CIPN (Levi, WHO, NCI-CTCAE, Sanofi-Synthelabo scale), SNCV, AE, incidence of severe digestive tract reaction/liver injury/kidney injury | Cochrane Collaboration’s RoB tool | National Natural Science Foundation of China (2017 publication) |
| Wei et al30 | PubMed, EMBASE, Cochrane Libraries, CNKI, VIP, Wanfang, reference lists; August 2015 | 3/193 | Cancer patients receiving oxaliplatin chemotherapy | RCTs | Oxaliplatin | Chinese herbal decoction (Dang Gui Si Ni decoction) | No treatment, conventional therapeutic agents | Incidence and severity of CIPN (Levi scale), SNCV, MNCV, AE | The modified Jadad scale | Tianjin (China) Municipal Health Bureau Research project |
| Wei et al31 | PubMed, EMBASE, Cochrane Libraries, CNKI, VIP, Wanfang, relevant journals; September 2015 | 8/489 | Cancer patients receiving oxaliplatin chemotherapy | RCTs | Oxaliplatin | Chinese herbal decoction (Bu Yang Huan Wu decoction) | Conventional therapeutic agents | Incidence and/or severity of CIPN (Levi, WHO scale), SNCV, MNCV | The modified Jadad scale | Tianjin (China) Municipal Health Bureau Research Project |
| Wei et al32 | PubMed, EMBASE, Cochrane Libraries, CNKI, VIP, Wanfang, relevant journals; August 2015 | 14/889 | Cancer patients receiving chemotherapy | RCTs | Not specified | Vitamin supplements | No treatment, placebo, conventional therapeutic agents | Incidence and severity of CIPN (Levi, WHO, NCI-CTCAE scale), TNS, NSS, SED | The modified Jadad scale | Tianjin (China) Municipal Health Bureau Research project |
| Derksen et al33 | PubMed, Embase, Google Scholar (1994-2015); December 2015 | 22/3093 | Colorectal cancer patients with chronic CIPN | RCTs, NRSIs, cohort studies, case series, cross-sectional studies, crossover studies | Oxaliplatin | Lifestyle related intervention (dietary supplements, physical activities, alternative and complementary therapies) | Not specified | Severity of CIPN (NCI-CTCAE, DEB-NTC, CIPNAT, EORTC QLQ-CIPN20, FACT/GOG-Ntx) | Not assessed | Alpe d’HuZes Foundation within the research program “Leven met kanker” of the Dutch Cancer Society; Kankeronderzoekfonds Limburg as part of Health Foundation Limburg |
| Brayall et al34 | CINAHL, PubMed, MEDLINE Complete, PEDro, Cochrane, Google Scholar, reference lists; January 2002 to January 2017 | 2/78 | Cancer patients with CIPN | RCTs | Not specified | Physical therapy (interactive sensor-based balance training; sensorimotor, endurance, strength training) | Not specified | Static/dynamic balance control; QoL peripheral deep sensitivity (gait speed and variability, sway of ankle, hip and COM with EO and EC in closed stance and semitandem stance; FES-I; EORTC QLQ-C30; IST, SGA) | STROBE scores | NR |
| Chen35 | PubMed, EMBASE, CBM, CNKI, Wanfang, VIP, dissertations, conference proceedings; October 2017 | 20/1452 | Cancer patients receiving oxaliplatin chemotherapy | RCTs | Oxaliplatin | Chinese herbal decoction (Huang Qi Gui Zhi Wu Wu decoction) | No intervention or western medicine | Incidence of OIPN; incidence of severe digestive tract reaction/liver injury/kidney injury; incidence of severe low white blood cell count/severe thrombocytopenia; AE | Cochrane Collaboration’s RoB tool | NR |
| Duregon et al36 | MEDLINE, Scopus, Bandolier, PEDro, Web of Science, reference lists; September 2017 | 5/147 | Cancer participants undergoing treatment diagnosed with CIPN | RCTs and pre- and postintervention comparison | Not specified | Physical exercise intervention (supervised-training intervention/home-based intervention) | Sensorimotor training, ankle point-to-point reaching, and virtual obstacle crossing tasks | CIPN symptoms (mTNS; FACT-Neurotoxicity); Static balance control (sway paths, mediolateral COM sway, hip sway, ankle sway, anteroposterior COM | Cochrane collaboration Back Review Criteria | Not funded by grants |
| sway, the Berg Balance Scale); dynamic balance control (sway paths); QoL (EORTC-QLQ-C-30, SF-36, FACT-O), fear of falling (FES-I), level of troublesome (McGill QOL Questionnaire) | ||||||||||
| Hoshino et al37 | Scopus, Ovid MEDLINE, CENTRAL, ICHUSHI, Google Scholar, reference lists; September 2016 | 5/386 | Cancer adults receiving hospital-based chemotherapy | RCTs | Oxaliplatin, docetaxel, paclitaxel | Goshajinkigan | Vitamin B12, placebo, no comparator | Incidence and/or severity of CIPN (CTCAE;DEB-NTC;VAS); incidence rate of AE with chemotherapy/SAE with Goshajinkigan/hematological toxicities (CTCAE), RECIST, rate of completion of chemotherapy | Cochrane Collaboration’s RoB tool | Japan Society for the Promotion of Science |
| Kuriyama and Endo38 | Medline, EMBASE, ICHUSHI, CENTRAL, Google scholar, reference lists; August, 2017 | 5/397 | Cancer adults receiving neurotoxic chemotherapy | RCTs | Oxaliplatin, docetaxel, paclitaxel | Goshajinkigan | Placebo, no intervention, and any agents that are currently known to not reduce or prevent CIPN (bathing in carbon dioxide-rich water; mecobalamin included) | Incidence rate of CIPN (CTCAE; DEB-NTC), response to chemotherapy, AEs to goshajinkigan, rate of completion of chemotherapy, disease control | Cochrane Collaboration’s RoB tool | NR |
| Liu et al39 | PubMed, Embase, CINAHL, AHMED, Cochrane Library, CBM, CQVIP, CNKI, Wanfang, reference lists; February 2018 | 63/4286 | Colorectal cancer adults had received or undergoing chemotherapy | Prospective RCTs | Oxaliplatin, cisplatin | Herbal medicines (orally and/or topically) used in traditional medicine in China, Korea, and/or Japan | Placebo, conventional chemotherapy, no additional intervention | The severity and/or incidence rate of CIPN (WHO, Levi, NCI-CTCAE, DEB-NTC), AE | Cochrane Collaboration’s RoB tool | The Australia International Research Centre for Chinese Medicine (CAIRCCM), the Foundation for Chinese Medicine and Technology Research of Guangdong Provincial Hospital of Chinese Medicine |
| Noh et al40 | MEDLINE, CENTRAL, EMBASE, AMED, CNKI, Wanfang, CQVIP, KSI, DBPIA, KISTI, the Research Information Centre for Health Database, KTKP, KoreaMed; May 17, 2017 | 28/2174 | Participants diagnosed with CIPN after chemotherapy | RCTs | Oxaliplatin, docetaxel, paclitaxel, NA | All types of herbal medicines | No treatment, placebo, conventional therapeutic agents | Remission rate (CR + PR), incidence rate (NCI-CTCAE, Levi), NCS, QoL | Cochrane Collaboration’s RoB tool | The Traditional Korean Medicine R&D Program funded by the Ministry of Health and Welfare through Korea Health Industry Development Institute (KHIDI) |
| Oh and Kim41 | PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, KoreaMed, KMbase, RISS, Nanet, KISS, Google Scholar; August 2017 | 22/954 | Cancer patients with CIPN | RCTs, NRSIs, case series, case reports, population-based survey, single-arm study, retrospective service evaluation | Not specified | Nondrug interventions | Not specified | Severity of CIPN (6MWT; ADL; CIPNAT; CTCAE; DGI; EC; EO; EORTC-QLQ CIPN20, EORTC-QLQ 30; EPIC; FACT/GOG-NTx; FACT-G; FES-I; HADS; LANSS; mCTSIB; MET; NPS; NRS; QOL; SF-12; TNSc; TNSr; TUG; VAS; VO2max; VPT) QoL, NCV, function tests, activity level | Cochrane Collaboration’s RoB tool | NR |
| Yan et al42 | CNKI, VIP, Wanfang, CBM, reference lists; July 2017 | 8/417 | Cancer patients with CIPN | RCTs | Not specified | Acupuncture | Placebo, conventional therapeutic agents | PNQ, NCV (SNCV, MNCV), VAS, FACT/GOG-NTX | The modified Jadad scale | NR |
| Yang et al43 | PubMed, CBM, Cochrane Library, CNKI, VIP, Wanfang; May 2017 | 8/805 | Cancer patients receiving oxaliplatin chemotherapy | RCTs | Oxaliplatin | External use of Chinese herbal medicine (herbal hand and foot baths; acupoint application) | Warm water bath, no treatment (nursing care) | Incidence and severity of CIPN (Levi scale) | Cochrane Collaboration’s RoB tool | National Natural Science Foundation of China |
| Li et al44 | PubMed, Cochrane Library, CNKI, CSPD; December 2018 | 20/1481 | Cancer adults diagnosed with CIPN | RCTs | Oxaliplatin, cisplatin, paclitaxel, NA | All types of ABDC herbal medicines | No additional control, placebo, conventional western medicine, warm water | The severity and/or incidence rate (WHO, NCI-CTCAE, Levi, CR + PR), NCV (SNCV, MNCV), QoL (KPS, ECOG), AE | Cochrane Collaboration’s RoB tool | Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents; Pro Program for the Cultivation of Youth talents in China Association of Chinese Medicine; Zhejiang Provincial Program for the Cultivation of the Young and Middle-Aged Academic Leaders in Colleges and universities; Zhejiang Pro Provincial Project for the key discipline of Traditional Chinese medicine |
| Li et al45 | EMBASE, Web of Science, MEDLINE, CENTRAL, CINAHL, the ClinicalTrials.gov Websites, the AcuTrials database, google scholar; May 2017 | 3/203 | Participants diagnosed with CIPN | RCTs | Taxanes, platinum derivative, vinca alkaloids | All type of acupuncture (acupuncture, electro-acupuncture, acupressure as an adjunctive or main intervention) | Placebo, sham acupuncture, conventional western medicine, hydroelectric bath | Pain, numbness, tingling, cold sensitivity, or any other signs of PN, subjective patient reports, surrogate markers, ADL, QoL, AE, changes in chemotherapy dosing | Cochrane Collaboration’s tool. The included studies generally had a low or unclear risk of bias | NR |
| Zhang et al46 | MEDLINE, EMBASE, CENTRAL, the US National Library of Health’s Clinical Trials registry, the WHO International Clinical Trials Registry Platform, February 2019 | 2/140 | Cancer patients undergoing chemotherapy | RCTs | Oxaliplatin, paclitaxel | Omega-3 polyunsaturated fatty acid oral supplements | Placebo or no intervention | Incidence of CIPN, NCS (SNCV, MNCV, SNAP, CMAP), AE | Cochrane Collaboration’s RoB tool | 2018 Melbourne Neuroscience Institute (MNI) Interdisciplinary Seed Fund grant |
Abbreviations: 6MWT, 6-minute walk test; ADL, activities of daily living; CBM, Chinese BioMedical Literature Database; CINAHL, Cumulative Index to Nursing and Allied Health Literature; CIPNAT, chemotherapy-induced peripheral neuropathy assessment tool; CMAP, compound motor action potential; CNKI, China National Knowledge Infrastructure; COM, center of mass; CQVIP, VIP Database for Chinese Technical Periodicals; CR, complete remission and the grade of CIPN reduced to 0 grade and all symptoms disappeared; CSPD, Wanfang Database of China Science Periodical Database; DEB-NTC, Neurotoxicity Criteria of Debiopharm; DGI, dynamic gait index; EC, eyes closed; EO, eyes opened; EORTC-QLQ (CIPN20/C30), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy scale; EPIC, European Prospective Investigation into Cancer; FACT/GOG-NTx, Functional Assessment of Cancer Therapy/Gynecological Oncology Group–Neurotoxicity; FACT-G/O, Functional Assessment of Cancer Therapy–General/Ovarian Cancer-Specific Scale; FES-I, Falls Efficacy Scale International; HADS, Hospital Anxiety and Depression Scale; ICHUSHI, Japanese Database of Scientific Literature and Abstracts of Scientific Meetings; IST, Incremental Step Test; KISS, Korean Information Service System; KISTI, The Korea Institute of Science and Technology Information; KMbase, Korean studies Medical Database; KoreaMed, Korean Association of Medical Journal Editors; KSI, Korean Studies Information; LANSS, Leeds Assessment of Neuropathic Symptoms and Sign; mCTSIB, modified Clinical Test for Sensory Interaction in Balance; MET, metabolic equivalent; mTNS, Modified Total Neuropathy Score; Nanet, National Assembly Library of Korea; NCI-CTCAE, the National Central Cancer Institute Common Terminology Criteria for Adverse Events; NCS, nerve conduction studies; NCV, nerve conduction velocity; NHMRC, the Australian National Health and Medical Research; NPS, Neuropathy Pain Scale; NRS, Neuropathic Symptoms on Numerical Rating Scale; NSS, Neurological Severity Score; OCEBM, the Oxford Center for Evidence Based Medicine; PNQ, Patient Neurotoxicity Questionnaire; PR, partial remission; QOL, quality of life; RECIST, rate of response to chemotherapy; RISS, Research Information Service System; SED, symptom examination daily; SGA, Subjective Global Assessment; SF-12, Short-Form Health Survey–12; SF-36, 36-Item Short-Form Survey; SNAP, sensory nerve action potential; STROBE, Strengthening the Reporting of Observational Studies in Epidemiology; TNS, Total Neurological Score; TNSc, Clinical Total Neuropathy Score; TNSr, Total Neuropathy Score Reduced; TUG, timed up and go; VAS, Visual Analogue Scale; VO2max, maximal oxygen consumption; VPT, vibration perception threshold.