Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy-induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000-24.

Abstract

Introduction: Although the prevalence of chemotherapy-induced peripheral neuropathy (CIPN) has been reported, the proportion of patients with CIPN who report chronic painful neuropathy remains poorly understood, despite its significant impact on patients' quality of life and treatment outcomes.

Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcome was the pooled prevalence of chronic (≥3 months) painful CIPN among patients diagnosed with CIPN. Estimates from each study were transformed using double arcsine transformation and pooled in a meta-analysis using an inverse variance heterogeneity model. Subgroup analysis was conducted based on geographical region, sex, chemotherapy regimen, primary cancer type, and funding source; meta-regression analysis was conducted based on study design, human development index (HDI), and publication year.

Results: 77 studies from 28 countries, encompassing 10 962 patients with CIPN, were included. Among patients diagnosed with CIPN, the pooled prevalence of those reporting chronic painful CIPN was estimated at 41.22% (95% CI 32.40 to 50.19; 95% prediction interval 23.71 to 61.28). Substantial heterogeneity was observed across studies (I²=95.27%; 95% CI for I² 94.58 to 95.86). Subgroup analysis revealed that patients treated with platinum based agents and taxanes had the highest prevalence of chronic painful CIPN (40.44% and 38.35%, respectively), and among primary cancers, those with lung cancer reported the highest prevalence of chronic painful CIPN (60.26%). Study design, HDI, and publication year were non-significant moderators of prevalence estimates. Based on our GRADE (Grading of Recommendations, Assessment, Development and Evaluation) assessment, the certainty of evidence was considered very low.

Conclusion: This study provides the first comprehensive global estimate of the prevalence of chronic painful CIPN, highlighting its significant burden on patients worldwide. The variation in prevalence across geographical regions, chemotherapy regimens, and primary cancers underscores the need for tailored pain management strategies and further research to address potential disparities.

Trial registration: PROSPERO CRD42024579459.