Effectiveness of Compression Therapy for the Prevention of Taxane-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis.

Abstract

Purpose: To evaluate the prophylactic efficacy of compression therapy for taxane-induced peripheral neuropathy (TIPN).

Methods: Systematically searched Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, Wan Fang, CBM, and VIP databases from inception to January 30, 2026. Included Randomized clinical trial (RCT) and quasi-Randomized clinical trials (quasi-RCTs). Two investigators independently screened studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool (RoB 1.0) for RCTs and the Joanna Briggs Institute (JBI) critical appraisal checklist for quasi-RCTs. Data were analyzed using Rev Man version 5.3, with subgroup analyses conducted according to study design, chemotherapy regimen, compression modality, and chemotherapy cycles.

Results: Eleven studies were included, comprising six RCTs and five quasi-RCTs and involving a total of 737 patients. Compression therapy reduced overall TIPN incidence (RR=0.63, 95% CI: 0.47-0.83) and the incidence of CTCAE grade ≥2 and PNQ grade ≥D sensory and motor neuropathy. The single quasi-RCT assessing overall TIPN also reported a lower incidence with compression therapy (1/94 vs 10/94). Among the quasi-RCTs, compression therapy reduced CTCAE grade ≥2 motor neuropathy (RR=0.56, 95% CI: 0.35-0.89), whereas the sensory and PNQ outcomes were not statistically significant. CIPNAT scores were lower with compression therapy (MD=-34.72, 95% CI: -52.16 to -17.29). No subgroup differences were found by chemotherapy regimen, compression modality, or number of chemotherapy cycles. Compression therapy was generally well tolerated.

Conclusion: Compression therapy may reduce the incidence of TIPN, but the findings should be interpreted cautiously because of the inclusion of quasi-RCTs, limited blinding, and heterogeneity in outcome measures. Further well-designed randomized controlled trials are needed to confirm these findings.