Effects of Integrative Approaches for the Management of Chemotherapy-Induced Peripheral Neuropathy in Colorectal Cancer Patients: A Systematic Review of Randomized Controlled Trials and Quasi-Experimental Studies.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and painful side effect of cancer treatment that causes numbness, tingling, and pain in the hands and feet. Researchers reviewed 13 studies involving 638 colorectal cancer patients to see if integrative therapies could help manage these symptoms.

The review found that multimodal exercise programs (combining different types of exercise) showed the most promise for reducing CIPN severity. Two high-quality studies demonstrated significant improvement in neuropathy symptoms immediately after exercise programs, with benefits lasting up to four weeks. Exercise interventions also improved quality of life, balance, and pain levels in patients experiencing CIPN.

Other approaches showed mixed results. Massage therapy, hand-foot exercises, and henna application demonstrated positive effects on neuropathy symptoms. A Japanese herbal medicine called Goshajinkigan appeared to prevent CIPN from worsening rather than improving existing symptoms. However, aerobic exercise alone, acupuncture, and therapeutic ultrasound did not show significant benefits for CIPN management in colorectal cancer patients specifically.

The study's limitations include small sample sizes and lack of long-term follow-up data. Most studies only measured short-term effects, and no research has yet examined psychological interventions for CIPN in this patient population.

For colorectal cancer patients experiencing peripheral neuropathy, these findings suggest that structured multimodal exercise programs may offer meaningful symptom relief, particularly when combined with conventional care. If you're considering acupuncture or other integrative therapies for CIPN management, consult with a licensed acupuncturist experienced in oncology care.

This systematic review evaluated integrative approaches for chemotherapy-induced peripheral neuropathy (CIPN) in colorectal cancer patients across 13 studies (n=638). Methodological quality was assessed using the EPHPP tool. Meta-analysis of two RCTs demonstrated multimodal exercise programs significantly reduced CIPN severity post-intervention (SMD=-0.70, 95% CI -1.36 to -0.07, p=0.03), with sustained effects at four-week follow-up (Cohen's d=0.58, p=0.031). Exercise interventions additionally improved quality of life, balance, and pain outcomes (p<0.05). Massage therapy, hand-foot exercise, and henna application showed immediate post-intervention benefits for neuropathy. Goshajinkigan prevented CIPN worsening rather than symptom improvement. Notably, acupuncture (n=1 study), aerobic exercise alone (n=2), and therapeutic ultrasound (n=1) failed to demonstrate significant CIPN benefits in CRC patients. Clinical implications favor multimodal exercise as first-line integrative intervention, though small sample sizes and heterogeneity limit generalizability. No psychological interventions have been studied for CIPN in this population.