CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: A COMPREHENSIVE REVIEW OF PATHOPHYSIOLOGY, CLINICAL MANIFESTATIONS AND MANAGEMENT STRATEGIES
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a side effect of chemotherapy that damages peripheral nerves, causing sensory, motor, and autonomic abnormalities that significantly decrease the quality of life for cancer patients. Characterized by symptoms such as numbness and tingling, the incidence of CIPN can reach 68% in the first month post-therapy. The severity of this condition often forces a dose reduction or discontinuation of chemotherapy, which can compromise the effectiveness of cancer treatment. Based on this literature review of the last 10 years, CIPN is a significant clinical challenge. Therefore, comprehensive clinical guidelines for its diagnosis, symptom management, and prevention are needed to optimize cancer therapy outcomes
References
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Staff, N.P. et al. (2020) “Pathogenesis of paclitaxel-induced peripheral neuropathy: A current review of in vitro and in vivo findings using rodent and human model systems,” Experimental Neurology. Academic Press Inc. Available at: https://doi.org/10.1016/j.expneurol.2019.113121.
Starobova, H. and Vetter, I. (2017) “Pathophysiology of chemotherapy-induced peripheral neuropathy,” Frontiers in Molecular Neuroscience. Frontiers Media S.A. Available at: https://doi.org/10.3389/fnmol.2017.00174.
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Triarico, S. et al. (2021) “Vincristine-induced peripheral neuropathy (Vipn) in pediatric tumors: Mechanisms, risk factors, strategies of prevention and treatment,” International Journal of Molecular Sciences. MDPI. Available at: https://doi.org/10.3390/ijms22084112.
Wang, C., Chen, S. and Jiang, W. (2022) “Treatment for chemotherapy-induced peripheral neuropathy: A systematic review of randomized control trials,” Frontiers in Pharmacology. Frontiers Media S.A. Available at: https://doi.org/10.3389/fphar.2022.1080888.
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Zajaczkowską, R. et al. (2019) “Mechanisms of chemotherapy-induced peripheral neuropathy,” International Journal of Molecular Sciences. MDPI AG. Available at: https://doi.org/10.3390/ijms20061451.
Zhang, X., Chen, W.-W. and Huang, W.-J. (2017) “Chemotherapy-induced peripheral neuropathy,” Biomedical Reports, 6(3), pp. 267–271. Available at: https://doi.org/10.3892/br.2017.851.
Avallone, A. et al. (2022) “Pathophysiology and Therapeutic Perspectives for Chemotherapy-induced Peripheral Neuropathy,” Anticancer Research. International Institute of Anticancer Research, pp. 4667–4678. Available at: https://doi.org/10.21873/anticanres.15971.
Bonhof, C.S. et al. (2019) “Anxiety and depression mediate the association between chemotherapy‐induced peripheral neuropathy and fatigue: Results from the population‐based PROFILES registry,” Psycho-Oncology, 28(9), pp. 1926–1933. Available at: https://doi.org/10.1002/pon.5176.
Brett Whalen, L. et al. (2022) “Beneficial effects of exercise on chemotherapy-induced peripheral neuropathy and sleep disturbance: A review of literature and proposed mechanisms,” Gynecologic Oncology Reports. Elsevier B.V. Available at: https://doi.org/10.1016/j.gore.2022.100927.
Brewer, J.R. et al. (2016) “Chemotherapy-induced peripheral neuropathy: Current status and progress,” Gynecologic Oncology. Academic Press Inc., pp. 176–183. Available at: https://doi.org/10.1016/j.ygyno.2015.11.011.
Burgess, J. et al. (2021) “Chemotherapy-Induced Peripheral Neuropathy: Epidemiology, Pathomechanisms and Treatment,” Oncology and Therapy. Adis, pp. 385–450. Available at: https://doi.org/10.1007/s40487-021-00168-y.
Colvin, L.A. (2019) “Chemotherapy-induced peripheral neuropathy: Where are we now?,” Pain. Lippincott Williams and Wilkins, pp. S1–S10. Available at: https://doi.org/10.1097/j.pain.0000000000001540.
Desforges, A.D. et al. (2022) “Treatment and diagnosis of chemotherapy-induced peripheral neuropathy: An update,” Biomedicine and Pharmacotherapy. Elsevier Masson s.r.l. Available at: https://doi.org/10.1016/j.biopha.2022.112671.
Eldridge, S., Guo, L. and Hamre, J. (2020) “A Comparative Review of Chemotherapy-Induced Peripheral Neuropathy in In Vivo and In Vitro Models,” Toxicologic Pathology. SAGE Publications Inc., pp. 190–201. Available at: https://doi.org/10.1177/0192623319861937.
Genevois, A.L. et al. (2021) “Analgesic Effects of Topical Amitriptyline in Patients With Chemotherapy-Induced Peripheral Neuropathy: Mechanistic Insights From Studies in Mice,” Journal of Pain, 22(4), pp. 440–453. Available at: https://doi.org/10.1016/j.jpain.2020.11.002.
Gewandter, J.S. et al. (2020) “Chemotherapy-induced peripheral neuropathy (CIPN) and its treatment: an NIH Collaboratory study of claims data,” Supportive Care in Cancer, 28(6), pp. 2553–2562. Available at: https://doi.org/10.1007/s00520-019-05063-x.
Guo, S. et al. (2023) “Effects of exercise on chemotherapy-induced peripheral neuropathy in cancer patients: a systematic review and meta-analysis,” Journal of Cancer Survivorship, 17(2), pp. 318–331. Available at: https://doi.org/10.1007/s11764-022-01182-3.
Hammi, C. and Yeung, B. (2022) “Neuropathy,” Statpearls [Preprint].
Huang, M.C. et al. (2023) “Acupuncture May Help to Prevent Chemotherapy-Induced Peripheral Neuropathy: A Randomized, Sham-Controlled, Single-Blind Study,” Oncologist, 28(6), pp. E436–E447. Available at: https://doi.org/10.1093/oncolo/oyad065.
Hung, H.-W. et al. (2021) “Impact of Chemotherapy-Induced Peripheral Neuropathy on Quality of Life in Patients with Advanced Lung Cancer Receiving Platinum-Based Chemotherapy,” International Journal of Environmental Research and Public Health, 18(11), p. 5677. Available at: https://doi.org/10.3390/ijerph18115677.
Ibrahim, E.Y. and Ehrlich, B.E. (2020) “Prevention of chemotherapy-induced peripheral neuropathy: A review of recent findings,” Critical Reviews in Oncology/Hematology. Elsevier Ireland Ltd. Available at: https://doi.org/10.1016/j.critrevonc.2019.102831.
Jordan, B. et al. (2019) “Prevention and management of chemotherapy-induced polyneuropathy,” Breast Care. S. Karger AG, pp. 79–84. Available at: https://doi.org/10.1159/000499599.
Kang, L. et al. (2021) “Oxaliplatin-induced peripheral neuropathy: clinical features, mechanisms, prevention and treatment,” Journal of Neurology. Springer Science and Business Media Deutschland GmbH, pp. 3269–3282. Available at: https://doi.org/10.1007/s00415-020-09942-w.
Kim, E. (2020) “Chemotherapy-induced peripheral neuropathy: Bench to clinical practice,” Korean Journal of Pain. Korean Pain Society, pp. 291–293. Available at: https://doi.org/10.3344/kjp.2020.33.4.291.
Lehmann, H.C. et al. (2020) “Diagnosis of peripheral neuropathy,” Neurological Research and Practice, 2(1). Available at: https://doi.org/10.1186/s42466-020-00064-2.
Lu, W. et al. (2020) “Acupuncture for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial,” The Oncologist, 25(4), pp. 310–318. Available at: https://doi.org/10.1634/theoncologist.2019-0489.
Maihöfner, C. et al. (2020) “Chemotherapy-induced peripheral neuropathy (CIPN): current therapies and topical treatment option with high-concentration capsaicin,” Supportive Care in Cancer [Preprint]. Available at: https://doi.org/10.1007/s00520-021-06042-x/Published.
Mezzanotte, J.N. et al. (2022) “Updates in the Treatment of Chemotherapy-Induced Peripheral Neuropathy,” Current Treatment Options in Oncology. Springer, pp. 29–42. Available at: https://doi.org/10.1007/s11864-021-00926-0.
Omran, M. et al. (2021) “Review of the Role of the Brain in Chemotherapy-Induced Peripheral Neuropathy,” Frontiers in Molecular Biosciences, 8. Available at: https://doi.org/10.3389/fmolb.2021.693133.
Quintão, N.L.M. et al. (2019) “Pharmacological Treatment of Chemotherapy-Induced Neuropathic Pain: PPARγ Agonists as a Promising Tool.,” Frontiers in neuroscience, 13, p. 907. Available at: https://doi.org/10.3389/fnins.2019.00907.
Staff, N.P. et al. (2017) “Chemotherapy-induced peripheral neuropathy: A current review,” Annals of Neurology. John Wiley and Sons Inc., pp. 772–781. Available at: https://doi.org/10.1002/ana.24951.
Staff, N.P. et al. (2020) “Pathogenesis of paclitaxel-induced peripheral neuropathy: A current review of in vitro and in vivo findings using rodent and human model systems,” Experimental Neurology. Academic Press Inc. Available at: https://doi.org/10.1016/j.expneurol.2019.113121.
Starobova, H. and Vetter, I. (2017) “Pathophysiology of chemotherapy-induced peripheral neuropathy,” Frontiers in Molecular Neuroscience. Frontiers Media S.A. Available at: https://doi.org/10.3389/fnmol.2017.00174.
Szklener, K. et al. (2022) “Dietary Supplements in Chemotherapy-Induced Peripheral Neuropathy: A New Hope,” Nutrients [Preprint].
Triarico, S. et al. (2021) “Vincristine-induced peripheral neuropathy (Vipn) in pediatric tumors: Mechanisms, risk factors, strategies of prevention and treatment,” International Journal of Molecular Sciences. MDPI. Available at: https://doi.org/10.3390/ijms22084112.
Wang, C., Chen, S. and Jiang, W. (2022) “Treatment for chemotherapy-induced peripheral neuropathy: A systematic review of randomized control trials,” Frontiers in Pharmacology. Frontiers Media S.A. Available at: https://doi.org/10.3389/fphar.2022.1080888.
Yamamoto, S. and Egashira, N. (2021) “Pathological mechanisms of bortezomib-induced peripheral neuropathy,” International Journal of Molecular Sciences, 22(2), pp. 1–14. Available at: https://doi.org/10.3390/ijms22020888.
Zajaczkowską, R. et al. (2019) “Mechanisms of chemotherapy-induced peripheral neuropathy,” International Journal of Molecular Sciences. MDPI AG. Available at: https://doi.org/10.3390/ijms20061451.
Zhang, X., Chen, W.-W. and Huang, W.-J. (2017) “Chemotherapy-induced peripheral neuropathy,” Biomedical Reports, 6(3), pp. 267–271. Available at: https://doi.org/10.3892/br.2017.851.
Published
2025-09-30
How to Cite
AULIA, Rashieka Salma; INDRIAWAN, Ramses.
CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: A COMPREHENSIVE REVIEW OF PATHOPHYSIOLOGY, CLINICAL MANIFESTATIONS AND MANAGEMENT STRATEGIES.
Mandala Of Health, [S.l.], v. 18, n. 2, p. 225-233, sep. 2025.
ISSN 2615-6954.
Available at: <https://jos.unsoed.ac.id/index.php/mandala/article/view/17802>. Date accessed: 16 oct. 2025.
doi: https://doi.org/10.20884/1.mandala.2025.18.2.17802.
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Articles
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