CN-16 * INCIDENCE, PREVALENCE AND PREDICTORS OF CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

BACKGROUND: Chemotherapy Induced Peripheral Neuropathy (CIPN) is a disabling side effect of chemotherapy. Severe CIPN may require chemotherapy dose reduction or cessation. There is no effective CIPN prevention strategy; treatment of established CIPN is limited, and the prevalence of CIPN is not known. Here we aim to calculate overall CIPN prevalence from published studies, and to identify risk factors for CIPN. METHODS: We used systematic review to identify studies reporting the prevalence of CIPN, and used random effects meta-regression to estimate the overall prevalence. We assessed study quality using the CONSORT and STROBE guidelines. We provide a qualitative summary of factors reported to alter the risk of CIPN. RESULTS: We included 31 studies with data from 4179 patients in our analysis. CIPN prevalence was 68.1% (57.7 to 78.4) when measured in the first month after chemotherapy, 60.0% (36.4 to 81.6) at three months and 30.0% (6.4 to 53.5) at six months or more. Different chemotherapy drugs were associated with differences in CIPN prevalence, and there was some evidence of publication bias. Genetic risk factors were reported in four studies. Clinical risk factors, identified in 4 of 31 studies, included neuropathy at baseline, smoking, abnormal creatinine clearance and specific sensory changes during chemotherapy. CONCLUSIONS: Although CIPN prevalence decreases with time, at six months 30% of patients continue to suffer from CIPN. Routine CIPN surveillance during post chemotherapy follow-up is needed. A number of genetic and clinical risk factors were identified that require further study.