Presentation summary

Introduction :
This systematic review and meta-analysis evaluated the preventive efficacy and safety of orally-administered traditional herbal medicine (THM) for the management chemotherapy-indeced peripheral neuropathy (CIPN) in patients with cancer.

Method :
Randomized controlled trials (RCTs) evaluating the efficacy of orally administered THM in theprevention of CIPN published up to 30 April 2024 were retrieved from nine databases. The primary outcomewas the incidence of CIPN, and the secondary outcomes included changes in neuropathic pain intensity, nerveconduction study parameters, Karnofsky Performance Scale (KPS) scores, and the incidence of adverseevents. Key herbal combinations were identified by conducting an association rule analysis

Results :
Thirty-seven RCTs involving 2,882 patients were included. Significant differences were observed between THM and the placebo [RR 0.83, 95% CI 0.74–0.93, p < 0.05], usual care [RR 0.51, 95% CI 0.37–0.69, p < 0.05], and no treatment [RR 0.62, 95% CI 0.54–0.71, p < 0.05] in terms of in the incidence rate ofCIPN. A significant reduction in the intensity of neuropathic pain [SMD -0.81, 95% CI -1.07 to −0.56, p < 0.05]and a significant improvement in KPS [MD 8.18, p < 0.05] were observed in the THM compared to notreatment. Furthermore, compared with usual care and no treatment, the use of THM yielded a significant improvement in the nerve conduction parameters with low quality of evidence. No serious adverse events were reported. The combination of Astragali Radix and Cinnamomi Ramulus as the strongest herbal combinationused for the prevention of CIPN.

Conclusion :
THM may be a promising option for the prevention of CIPN in patients with cancer. Further well-designed and rigorously reported randomized controlled trials are warranted to confirm these findings andclarify their clinical applicability.