title: Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis.
abstract: Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling pain condition resulting from chemotherapy for cancer. Severe acute CIPN may require chemotherapy dose reduction or cessation. There is no effective CIPN prevention strategy; treatment of established chronic CIPN is limited, and the prevalence of CIPN is not known. Here we used a systematic review to identify studies reporting the prevalence of CIPN. We searched Embase, Medline, CAB Abstracts, CINAHL, PubMed central, Cochrane Library, and Web of Knowledge for relevant references and used random-effects meta-regression to estimate overall prevalence. We assessed study quality using the CONSORT and STROBE guidelines, and we report findings according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. We provide a qualitative summary of factors reported to alter the risk of CIPN. We included 31 studies with data from 4179 patients in our analysis. CIPN prevalence was 68.1% (57.7-78.4) when measured in the first month after chemotherapy, 60.0% (36.4-81.6) at 3months and 30.0% (6.4-53.5) at 6months or more. Different chemotherapy drugs were associated with differences in CIPN prevalence, and there was some evidence of publication bias. Genetic risk factors were reported in 4 studies. Clinical risk factors, identified in 4 of 31 studies, included neuropathy at baseline, smoking, abnormal creatinine clearance, and specific sensory changes during chemotherapy. Although CIPN prevalence decreases with time, at 6months 30% of patients continue to suffer from CIPN. Routine CIPN surveillance during post-chemotherapy follow-up is needed. A number of genetic and clinical risk factors were identified that require further study.
authors.affiliation: Cancer Research UK, University of Edinburgh, Edinburgh, Scotland, UK Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK Western General Hospital, University of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: Marta
authors.initials: M
authors.lastname: Seretny
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Currie
authors.forename: Emily S
authors.initials: ES
authors.lastname: Sena
authors.forename: Sabrina
authors.initials: S
authors.lastname: Ramnarine
authors.forename: Robin
authors.initials: R
authors.lastname: Grant
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: MacLeod
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Colvin
authors.forename: Marie
authors.initials: M
authors.lastname: Fallon
mesh_terms: D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004358:Drug Therapy; D064420:Drug-Related Side Effects and Adverse Reactions / Q000150:complications*; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology*; D011237:Predictive Value of Tests
keywords: Chemotherapy-induced peripheral neuropathy (CIPN); Meta-analysis; Prevalence; Risk factors; Systematic review