title: Current use of drugs affecting the central nervous system for chemotherapy-induced peripheral neuropathy in cancer patients: a systematic review.
abstract: OBJECTIVE
  Chemotherapy-induced peripheral neuropathy (CIPN) is common among cancer patients who undergo chemotherapy with platinum analogues, taxanes, vinca alkaloids, epothilone, bortezomib, and thalidomide. The purpose of this study was to investigate the evidence of using drugs affecting the central nervous system (CNS) to alleviate CIPN in cancer patients.
  
  
  METHODS
  A systematic literature search was conducted using the CINAHL, EMBASE, and Medline databases to identify randomized controlled clinical trials (RCTs) reported in English up to 2013. We identified ten trials of CNS-acting drugs used to treat CIPN in cancer patients and reviewed efficacy and safety of CNS-acting drugs for CIPN using a standard data collection form. The risk of bias in each RCT was also assessed.
  
  
  RESULTS
  Antidepressants were used in six studies and anticonvulsants in four studies. We found positive results for amitriptyline (topical), venlafaxine, and oxcarbazepine in one study each, but the results were not sufficient to draw definite conclusions. One trial with duloxetine showed a moderate effect (effect size, 0.513, P = .003) on CIPN pain relief. However, none of the results has yet been duplicated in an RCT with a large sample size.
  
  
  CONCLUSIONS
  Insufficient RCTs exist to confirm the efficacy of CNS agents to reduce CIPN. This study highlighted the need for and the importance of conducting well-designed RCTs to generate evidence on CIPN symptom management. Additional RCTs are warranted to accelerate the potential use of CNS drugs for CIPN in cancer patients.
authors.affiliation: Department of Clinical Nursing Science, Yonsei University College of Nursing, Nursing Policy Research Institute, Biobehavioral Research Center, 50 Yonsei-ro, Seodaemun-Gu, Seoul, 120-752, South Korea, shchu@yuhs.ac.
authors.forename: Sang Hui
authors.initials: SH
authors.lastname: Chu
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Eon Sook
authors.initials: ES
authors.lastname: Lee
authors.forename: Yimin
authors.initials: Y
authors.lastname: Geng
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
mesh_terms: D000639:Amitriptyline / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001897:Boronic Acids / Q000009:adverse effects / Q000627:therapeutic use; D000069286:Bortezomib; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D002490:Central Nervous System / Q000187:drug effects*; D003511:Cyclohexanols / Q000627:therapeutic use; D000068736:Duloxetine Hydrochloride; D034261:Epothilones / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D009437:Neuralgia / Q000188:drug therapy; D000078330:Oxcarbazepine; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000188:drug therapy*; D011719:Pyrazines / Q000009:adverse effects / Q000627:therapeutic use; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use; D013792:Thalidomide / Q000009:adverse effects / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use; D000069470:Venlafaxine Hydrochloride; D014748:Vinca Alkaloids / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D000970:Antineoplastic Agents; D001897:Boronic Acids; D003511:Cyclohexanols; D034261:Epothilones; D011719:Pyrazines; D043823:Taxoids; D013876:Thiophenes; D014748:Vinca Alkaloids; D000639:Amitriptyline; D002220:Carbamazepine; D013792:Thalidomide; D000069286:Bortezomib; D000069470:Venlafaxine Hydrochloride; D000068736:Duloxetine Hydrochloride; D000078330:Oxcarbazepine