Table 2.

Summary of characteristics and findings of studies that examined the effect of non-pharmacological self-management interventions on chemotherapy-induced peripheral neuropathy symptoms and related outcomes in people with advanced cancer.

Study and Population Characteristics				Intervention Characteristics		Findings
						CIPN			CIPN-Related Outcomes
Citation and Country	Population	Cancer	CTX	Intervention	Control	Tool and Time Point	Incidence	Severity	Quality of Life	Physical function	Pain	Sleep	Fatigue	GI symptoms	Nutrition status	Psychological	Social	Treatment	Financial	Adverse events
Physical exercise
Henke 2014 [31]; Germany	N: 46 Age (yrs): NR Males: NR	Type: lung Stage: ≥3 Existing CIPN: NR	Type: Platinum-based Frequency: NR Duration: NR Status: ongoing	Strategy: Strength and endurance training (n = 25) Regimen: 8 min endurance or 3 sets of 4 strength exercises daily Duration: 3 CTX cycles, from C1D1	Standard care (n = 21)	EORTC QLQ-LC13; pre and post (C3)		+	+	+	+	o	o	o		o	o		o
Stuecher 2019 [32]; Germany	N: 44 Age (yrs): 67 ± 8 Males: 67%	Type: gastrointestinal Stage: ≥3 Existing CIPN: no	Type: NR Frequency: NR Duration: NR Status: ongoing	Strategy: Walking (n = 22) Regimen: 150 min per wk Duration: 12 wks, from C1D1	Standard care (n = 22)	Tuning fork test; pre and post (6 and 12 wks)		o		+					+					o
Streckmann 2014 [33]; Germany	N: 61 Age (yrs): 46 (19–73) Males: 77%	Type: lymphoma Stage: progressive Existing CIPN: NR	Type: mixed Frequency: NR Duration: NR Status: ongoing	Strategy: Strength, endurance, and sensorimotor training (n = 30) Regimen: 1 h session twice per wk Duration: 36 wks	Standard care (n = 31)	Tuning fork test; pre and post (12, 24 and 36 wks)	+		o	+	o	+	+	+		+			+	o
Zimmer 2018 [34]; Germany	N: 30 Age (yrs): 50–81 Males: 70%	Type: colorectal Stage: 4 Existing CIPN: NR	Type: mixed Frequency: NR Duration: 2–3 cycles Status: ongoing and ceased	Strategy: Strength, endurance, and sensorimotor training (n = 17) Regimen: 1 hr session twice per wk Duration: 8 wks	Written exercise guidelines (n = 13)	FACT/GOG-NTX; pre and post (8 and 12 wks)		+	o	+						o	o			o
Nutrition supplements
Bradfield, 2015 [35]; USA	N: 200 Age (yrs): 9 ± 5 Males: 62%	Type: lymphoma Stage: NR Existing CIPN: no	Type: Vincristine Frequency: weekly Duration: ≥4 wks Status: ongoing	Strategy: L-glutamic acid in capsule form, taken orally (n = 101) Regimen: 3 times daily, total 0.75–1.5 g per day Duration: 5 wks	Placebo (n = 99)	mBPSPN; pre and post (5 wks)	o
Howells, 2019 [36]; UK	N: 27 Age (yrs): 68 (53–78) Males: NR	Type: colorectal Stage: metastatic Existing CIPN: no	Type: 5FU and oxaliplatin Frequency: fortnightly Duration: ≤12 cycles Status: ongoing	Strategy: Curcumin powder in capsule form, taken orally (n = 18) Regimen: 4 times daily, total 2 g per day Duration: duration of CTX (from 7 days before C1D1)	Standard care (n = 9)	EORTC-QLQ-C30 and NCI-CTAE; pre and post	-	o	o	o	o	o	o	-	o			+		o
Sanchez-Lara, 2014 [37]; Mexico	N: 112 Age (yrs): 18–80 Males: 47%	Type: NSCL Stage: ≥3 b Existing CIPN: NR	Type: paclitaxel and cisplatin/carboplatin Frequency: every wks Duration: 2–6 cycles Status: ongoing	Strategy: omega 3 (EPA)-enriched oral nutrition supplement + isocaloric diet (n = 54) Regimen: 2 237 mL drinks per day (provides 2.2 g EPA) Duration: 2 CTX cycles, from C1D1	Isocaloric diet (n = 58)	EORTC-QLQ-C30 and -LC13; pre and post (C1 and C2)		+	o	o			+	+	+			o		o
Wang, 2007 [38]; Taiwan	N: 86 Age (yrs): 60% ≥50 Males: 65%	Type: colorectal Stage: metastatic Existing CIPN: no	Type: 5FU and oxaliplatin Frequency: every 4 wks Duration: NR Status: ongoing	Strategy: Levo-Glutamine, taken orally (n = 42) Regimen: twice daily, total 30 g per day for 7 days every 2 wks Duration: 6 cycles, from C1D1	Standard care (n = 44)	NCI-CTCAE and Electro-physiological exam; pre and post (C2, C4 and C6)	+		+									+		o
Japanese herbal medicine
Motoo 2020 [39]; Japan	N: 52 Age (yrs): 35–79 Males: 60%	Type: colorectal Stage: 3 Existing CIPN: no	Type: capecitabine and oxaliplatin Frequency: every 3 wks Duration: 8 cycles Status: ongoing	Strategy: ninjin’yoeito powder 1, taken orally (n = 26) Regimen: 2–3 times daily, total 9 g per day Duration: 8 cycles, from C1D1	Standard care (n = 26)	NCI-CTCAE; pre and post (C1–C8)	+					o	o	o				+		o
Niskioka, 2011 [40]; Japan	N: 45 Age (yrs): 48–80 Males: 49%	Type: colorectal Stage: metastatic Existing CIPN: no	Type: 5FU and oxaliplatin Frequency: every 2 wks Duration: 4–32 cycles Status: ongoing	Strategy: Goshajinkigan 2, taken orally (n = 22) Regimen: 2–3 times daily, total 7.5 g per day Duration: entire CTX course (4–32 cycles), from C1D1	Standard care (n = 23)	DEB-NTC; pre and post (at each CTX cycle)	+							o				o		o
Oki, 2015 [41]; Japan	N: 186 Age (yrs): 61 ± 11 Males: 55%	Type: colorectal Stage: 3 Existing CIPN: no	Type: 5FU and oxaliplatin Frequency: every 2 wks Duration: 12 cycles Status: ongoing	Strategy: Goshajinkigan 2, taken orally (n = 93) Regimen: daily with meals, total 7.5 g per day Duration: entire CTX course (12 cycles), from C1D1	Placebo (n = 93)	NCI-CTCAE and DEB-NTC; pre and post (at each CTX cycle)	-						o	o				+		o
Technology-facilitated education for symptom self-management
Given, 2008 [42]; USA	N: 47 Age (yrs): ≥21 Males: 0%	Type: breast Stage: metastatic Existing CIPN: NR	Type: mixed Frequency: NR Duration: NR Status: ongoing	Strategy: Education for symptom self-management via automated telephone voice technology incorporating symptom monitoring (n = 24) Regimen: weekly phone calls for 4 wks, then at wk 6 and wk 8 Duration: 8 wks	Cognitive behavioral nurse-administered telephone symptom management (n = 23)	11-point Likert scale; pre and post (10 and 16 wks)	?			?	?	?	?	?		?
Kim, 2018 [43]; Korea	N: 76 Age (yrs): 51 ± 7 Males: 0%	Type: breast Stage: 4 Existing CIPN: NR	Type: mixed Frequency: NR Duration: NR Status: ongoing	Strategy: Education for symptom self-management via a mobile phone game (n = 36) Regimen: >30 min per day, 3 times per wk Duration: 3 wks	Symptom management booklet (n = 40)	NCI-CTCAE; pre and post (3 wks)	+		+	-				-		-	o	+		o

¹ Contains 12 crude Japanese herbs: Rehmannia root, Angelica root, Atractylodes rhizome, Poria Sclerotium, Ginseng, Cinnamon bark, Polygala root, Peony root, Citrus Unshiu peel, Atsragalus root, Glycyrrhiza, Schisandra fruit. ² Contains 10 crude Japanese herbs: Rehmannia root, Achyranthes root, Cornus fruit, Dioscorea rhizome, Plantago seed, Alisma Rhizome, Poria Sclerotium, Moutan bark, Cinnamon bark, and aconite root. . Statistically significant positive effect favoring intervention. . Statistically significant negative effect favoring control.. No statistically significant effect. . Statistical significance not tested. 5FU: Fluorouracil; C: chemotherapy cycle; CIPN: chemotherapy-induced peripheral neuropathy; CTX: chemotherapy; D: day; DEB-NTC: Neurotoxicity Criteria of Debiopharm; EORTC QLQ-C30: European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ-LC13: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer 13; EPA: eicosapentaenoic acid; FACT/GOG-NTX: Functional Assessment of Cancer Therapy Gynecologic Oncology Group Neurotoxicity; GI: Gastrointestinal; hr: hour; min: minutes; mBPSPN: Modified Balis Pediatric Scale of Peripheral Neuropathies; NCI-CTCAE: National Cancer Institute Common Terminology Criteria for Adverse Events; NSCL: non-small cell lung cancer; NR: not reported; UK: United Kingdom; USA: United States of America; wk: week; yrs: years.