Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline

作者：Dawn L. Hershman, Christina Lacchetti, Robert H. Dworkin, Elizabeth Smith, Jonathan Scott Bleeker, Guido Cavaletti, Cynthia Chauhan, Patrick G. Gavin, Antoinette Lavino, Maryam B. Lustberg, Judith A. Paice, Bryan Paul Schneider, Mary Lou Smith, Tom Smith, Shelby A. Terstriep, Nina D. Wagner‐Johnston, Kate Bak, Charles L. Loprinzi · 发表于：Journal of Clinical Oncology · 年份：2014 · DOI：10.1200/jco.2013.54.0914 · 被引用次数：1233 · 研究领域：Cancer Treatment and Pharmacology、Cancer-related cognitive impairment studies、Oral health in cancer treatment

PURPOSE: To provide evidence-based guidance on the optimum prevention and treatment approaches in the management of chemotherapy-induced peripheral neuropathies (CIPN) in adult cancer survivors. METHODS: A systematic literature search identified relevant, randomized controlled trials (RCTs) for the treatment of CIPN. Primary outcomes included incidence and severity of neuropathy as measured by neurophysiologic changes, patient-reported outcomes, and quality of life. RESULTS: A total of 48 RCTs met eligibility criteria and comprise the evidentiary basis for the recommendations. Trials tended to be small and heterogeneous, many with insufficient sample sizes to detect clinically important differences in outcomes. Primary outcomes varied across the trials, and in most cases, studies were not directly comparable because of different outcomes, measurements, and instruments used at different time points. The strength of the recommendations is based on the quality, amount, and consistency of the evidence and the balance between benefits and harms. RECOMMENDATIONS: On the basis of the paucity of high-quality, consistent evidence, there are no agents recommended for the prevention of CIPN. With regard to the treatment of existing CIPN, the best available data support a moderate recommendation for treatment with duloxetine. Although the CIPN trials are inconclusive regarding tricyclic antidepressants (such as nortriptyline), gabapentin, and a compounded topical gel containing baclofen,...