Influencing factors of chemotherapy-induced peripheral neuropathy in colorectal cancer: a systematic review and meta-analysis

A systematic review and meta-analysis of the influencing factors of chemotherapy induced peripheral neuropathy(CIPN) in colorectal cancer (CRC). An electronic literature search was carried out across PubMed, Web of Scienc, EMBASE, CINAHL, Cochrane Library, and SinoMed to locate research on factors influencing CIPN in CRC. The search encompassed records from the inception of the databases up to June 30, 2025. Two researchers conducted independent screenings of the studies, evaluated their quality, and extracted relevant data. Meta-analysis was performed utilizing RevMan software. A total of 10 studies involving 2008 patients were analyzed, from which 14 potential influencing factors were identified. The meta-analysis indicated that certain factors were significantly linked to a heightened risk of CIPN in individuals with CRC: age ≥ 60 years (OR = 1.47, 95% CI: 1.02 to 2.13), smoking history (OR = 1.55, 95% CI: 1.06 to 2.27), diabetes (OR = 2.18, 95% CI: 1.01 to 4.07), Hypomagnesemia(OR = 4.17, 95% CI: 2.00 to 8.33), cumulative oxaliplatin dose ≥ 500 mg/m² (OR = 1.79, 95% CI: 1.20 to 2.63), and Cold exposure (OR = 1.54, 95% CI: 1.03 to 2.30). The meta-analysis identifies several potential risk factors for CIPN in CRC, the thin evidence base across most subgroups precludes definitive conclusions. These findings should be regarded as hypothesis-generating, providing preliminary signals for future prospective studies designed to validate these associations and inform targeted interventions.