Can External Use of Chinese Herbal Medicine Prevent CumulativePeripheral Neuropathy Induced by Oxaliplatin? A Systematic Literature ReviewWith Meta-analysis

摘要

Peripheral neurotoxicity caused by oxaliplatin (OXA)chemotherapy is the main limitation preventing continuation of chemotherapy inpatients with gastrointestinal cancer. The purpose of this study was todetermine the efficacy of external use of Chinese herbal medicine (CHM) on theincidence of cumulative OXA-induced peripheral neurotoxicity (OIPN). Scientific literature databases were searched toidentify controlled clinical trials analyzing CHM in OIPN. Clinical studies thatincluded at least 1 relevant primary outcome were analyzed by 2 independentreviewers. Meta-analysis was performed on the software RevMan 5.3. 700 cancer patients of 9 studies were reported, ofwhom 352 received external CHM and 348 received warm water baths, conventionalmedicine, or no intervention as controls. Neurotoxicity incidence (Levi grade ≥1) was significantly decreased in CHM group, compared with no intervention( < .01). The incidence of cumulative neurotoxicity(Levi grade ≥2) was also significantly lower in the CHM group than in all thecontrol groups ( < .05), and the cumulative neurotoxicityin the CHM group was significantly reduced (Levi grade ≥ 3) in comparision withno intervention ( < .01). These results were consistentwith those of the subgroup analyses for preventing OIPN at each of thechemotherapy treatment cycles. There was no difference in the incidence ofadverse events between groups ( > .05). . External use of CHM may be beneficial inpreventing the OXA-induced cumulative neurotoxicity. However, given the lowquality of the evidence, the results should be interpreted with caution.