The effects of Chinese herbal fumigation on the prevention of peripheral neurotoxicity caused by chemotherapy:a meta-analysis

Backgroud:To evaluate the clinical efficacy of Chinese herbal fumigation to prevent peripheral neurotoxicity caused by chemotherapy.Methods:CNKI,VIP Database,Wanfang Database,PubMed and Cochrane Databases were searched from January 2014 to July 2019 for randomized controlled trials(RCTs)of herbal fumigation to prevent peripheral neurotoxicity caused by chemotherapy.The RCTs were selected according to the inclusion and exclusion criteria,and the data extraction and bias risk assessment were performed.RevMan 5.3 software was used for statistical analysis.Results:Five Chinese RCTs were eventually included,with a total of 331 patients.Meta-analysis showed that compared with the control group,herbal fumigation could significantly reduce the incidence of peripheral neurotoxicity induced by chemotherapy(OR=0.34,95%CI(0.21,0.55),P<0.01).Moreover,herbal fumigation could also reduce the incidence of peripheral neurotoxicity above grade 2(OR=0.17,95%CI(0.04,0.77)P=0.02).Conclusion:Herbal fumigation can effectively prevent the occurrence of peripheral neurotoxicity caused by chemotherapy without obvious adverse reactions.

Efficacy of Traditional Chinese Medicines in Preventing Oxaliplatin-induced Peripheral Neurotoxicity in Cancer Patients:A Network Meta-analysis

Objective Oxaliplatin-induced peripheral neurotoxicity（OIPN） is the main limitation for its continuation in cancer patients.Traditional Chinese medicines（TCMs） have been used to prevent OIPN in China and have been demonstrated to be effective.However,due to the lack of direct comparison among TCMs,it remains unclear that which TCM is the best for OIPN prevention.Consequently,the present study aimed to compare the relative efficacies of TCMs to find out the best TCM by applying a network meta-analysis.Methods Studies were identified by searching PubMed,EMbase,Cochrane Libraries,CNKI,WanFang,and WeiPu database from January 1990 to May2016.Randomized controlled trials（RCTs） that evaluated the efficacy of TCMs in preventing OIPN in cancer patients were included.Statistical analysis was performed with ADDIS 1.1 6.6.Results Twenty-five RCTs（1572 patients） involving five TCMs were included.The results of network meta-analyses showed that compared with oxaliplatin-based chemotherapy alone,the combination with Huangqi Injection（HQI）,Shenmai Injection（SMI）,Shenfu Injection（SFI）,Buyang Huanwu Decoction（BHD）,and Huangqi Guizhi Wuwu Decoction（HGWD） could decrease the overall OIPN incidence and the severe OIPN incidence in cancer patients.In addition,probability ranking results showed the order of efficacy in preventing overall OIPN incidence was HQI 〉 HGWD 〉 SFI =SMI 〉 BHD,while the order of efficacy in preventing severe OIPN incidence was HQI 〉HGWD 〉 BHD 〉 SFI = SMI.Conclusion All five TCMs are effective neuroprotective agents against OIPN.Among these TCMs,HQI and HGWD were superior to others in clinical efficacy.Moreover,Astragalus membranaceus might be a more promising herb for the OIPN prevention.However,more direct head-to-head RCTs with high quality and large sample size are still needed to further confirm the conclusion.

Psychosocial adaptation and influencing factors among patients with chemotherapy-induced peripheral neuropathy

BACKGROUND Chemotherapy-induced peripheral neuropathy(CIPN)is a severe and longlasting side effect caused by various anticancer agents that damage sensory,motor and autonomic nerves.It can cause maladaptive behaviors,including disease severity,anxiety,depression,sleep disorders,falls,and social impairment.These disorders have physical,psychological and social effects on patients and can seriously influence their quality of life.AIM To investigate the current situation of psychosocial adaptation to the disease and its influencing factor in patients with CIPN.METHODS A convenience sampling method was used to select 233 patients with CIPN in our hospital from February to August 2021.In addition,a cross-sectional survey was conducted using a sociodemographic questionnaire,the Self-Report Psychosocial Adjustment to Illness Scale,and the European Organisation for the Research and Treatment of Cancer Quality of Life CIPN20(QLQ-CIPN20).Factors influencing psychosocial adaptation in patients with CIPN were analyzed by t-test or one-way analysis of variance,correlation analysis,multiple stepwise regression analysis,and structural equation models.RESULTS The psychosocial adaptation score of patients with CIPN was 52.51±13.18.Multivariate analysis showed that autonomic nerves,tumor stage,motor nerves,education level,availability of caregivers,semi-retirement status,CIPN grade were independent risk factors for patients with CIPN(P<0.05).Structural equation models showed that QLQ-CIPN20 mediated the relationship between CIPN grade,tumor stage,and psychosocial adaptation.CONCLUSION Patients with CIPN have poor psychosocial adaptation and are affected by a variety of physiological,psychological,and social factors.Patients’adaptive responses should be assessed,and targeted interventions implemented.