Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: A systematic review

Crit Rev Oncol Hematol. 2016 Feb:98:325-34. doi: 10.1016/j.critrevonc.2015.11.014. Epub 2015 Nov 23.

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a serious dose-limiting side-effect without any FDA-approved treatment option. Prior reviews focus mostly on pharmacological interventions, but nonpharmaceutical interventions have also been evaluated. A Web of Science and PubMed database search to identify relevant RCTs from January 2005 to May 2015 included the terms: CIPN, cancer; and supplements, vitamin E, goshajinkigan, kampo, acetyl-L-carnitine, carnitine, alpha-lipoic acid, omega-3, glutamine, or glutamate; or massage, acupuncture, mind-body practice, yoga, meditation, Tai-Chi, physical activity, or exercise. Of 1465 publications screened, 12 RCTs evaluated natural products and one evaluated electroacupuncture. Vitamin E may help prevent CIPN. L-Glutamine, goshajinkigan, and omega-3 are also promising. Acetyl-L-carnitine may worsen CIPN and alpha-lipoic acid activity is unknown. Electroacupuncture was not superior to placebo. No RCTs were published regarding other complementary therapies, although some studies mention positive incidental findings. Natural products and complementary therapies deserve further investigation, given the lack of effective CIPN interventions.

Keywords: Chemotherapy; Complementary therapies; Dietary supplements; Integrative medicine; Natural products; Peripheral neuropathy; Platinum drugs; Randomized controlled trials.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acupuncture Therapy
  • Antineoplastic Agents / adverse effects*
  • Biological Products / therapeutic use*
  • Complementary Therapies*
  • Dietary Supplements
  • Exercise
  • Fatty Acids, Omega-3 / administration & dosage
  • Glutamine / administration & dosage
  • Humans
  • Peripheral Nervous System Diseases / chemically induced*
  • Peripheral Nervous System Diseases / therapy
  • Vitamin E / administration & dosage

Substances

  • Antineoplastic Agents
  • Biological Products
  • Fatty Acids, Omega-3
  • Glutamine
  • Vitamin E