Oral Chinese Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy: Systematic Review and Meta-analysis

It is estimated that about 30% of patients who received chemotherapy will develop chemotherapy-induced peripheral neuropathy ( CIPN ). Chinese herbal medicine is widely used to treat CIPN in China, but its efficacy has not been investigated. Our study aims to review the current literature on the effectiveness of oral herbal medicine in controlling the symptoms of CIPN. Up until July 2024, relevant international databases were searched. Chemotherapy-induced peripheral neuropathy treated with oral Chinese herbal medicine in randomised controlled trials was included. The effective rate of the improving grade of peripheral nerve injury, nerve conduction velocity, Karnofsky performance score ( KPS ), and traditional Chinese medicine ( TCM ) syndrome efficiency were the outcomes; the increase in ALT, AST, and the incidence of vomiting were used as safety indicators. This review included 14 articles. The overall effect of oral Chinese herbal medicine on CIPN is statistically significant, suggesting that herbal medicine can benefit patients suffering from CIPN. The intervention group shows significant differences in the effective rate of improving the grade of peripheral nerve injury ( P ＜0.05), sensory nerve conduction velocity ( P ≤ 0.05), KPSs ( P ＜0.05), and the TCM syndrome efficiency ( P ＜0.05) when compared with the control groups. However, the motor nerve conduction velocity ( P ＞0.05) shows no statistically significant difference. Oral Chinese herbal medicine is an effective method to relieve CIPN symptoms and can increase the effective rate of improving the grade of peripheral nerve injury, sensory nerve conduction velocity, KPSs, and TCM syndrome efficiency, and it has a good security. CRD42023493091. • Investigating oral Chinese herbs' effects on chemo-induced neurotoxicity. • Oral Chinese herbs alleviate chemo-neurotoxicity and enhance nerve function. • A new direction for treating chemotherapy-induced neurotoxicity.