背景:大多数接受某些化学疗法治疗的癌症患者患有CIPN。因此,患者和提供者对补充非药物疗法有很高的兴趣,但其证据基础尚未在CIPN的背景下被明确指出。方法:范围审查的结果概述了已发表的关于应用补充疗法改善复杂CIPN症状学的临床证据,并结合了专家共识程序的建议,旨在引起人们对CIPN支持策略的关注。范围审查,在PROSPERO2020(CRD42020165851)注册,遵循PRISMA-ScR和JBI指南。相关研究发表在Pubmed/MEDLINE,PsycINFO,PEDro,科克伦中部,包括2000年至2021年的CINAHL。CASP用于评估研究的方法学质量。结果:75项具有混合研究质量的研究符合纳入标准。手法治疗(包括按摩,反射疗法,治疗性触摸),有节奏的刺绣,运动和身心疗法,针灸/指压,和TENS/Scrambler疗法是研究中分析最频繁的疗法,可能是CIPN的有效治疗选择。专家小组批准了17项支持性干预措施,其中大多数是植物治疗干预措施,包括外部应用和冷冻疗法,水疗,和触觉刺激。超过三分之二的同意的干预措施在治疗使用中被评为中度至高度感知的临床有效性。结论:审查和专家小组的证据支持关于CIPN的支持性治疗的各种补充程序;然而,在每种情况下,患者的应用应单独称重。基于这种元合成,跨专业医疗团队可能会与对非药物治疗方案感兴趣的患者展开对话,以根据他们的需求定制补充咨询和治疗。
Background: Most individuals affected by cancer who are treated with certain chemotherapies suffer of CIPN. Therefore, there is a high patient and provider interest in complementary non-pharmacological therapies, but its evidence base has not yet been clearly pointed out in the context of CIPN. Methods: The results of a scoping review overviewing the published clinical evidence on the application of complementary therapies for improving the complex CIPN symptomatology are synthesized with the recommendations of an expert
consensus process aiming to draw attention to supportive strategies for CIPN. The scoping review, registered at PROSPERO 2020 (CRD 42020165851), followed the PRISMA-ScR and JBI
guidelines. Relevant studies published in Pubmed/MEDLINE, PsycINFO, PEDro, Cochrane CENTRAL, and CINAHL between 2000 and 2021 were included. CASP was used to evaluate the methodologic quality of the studies. Results: Seventy-five studies with mixed study quality met the inclusion criteria. Manipulative therapies (including massage, reflexology, therapeutic touch), rhythmical embrocations, movement and mind-body therapies, acupuncture/acupressure, and TENS/Scrambler therapy were the most frequently analyzed in research and may be effective treatment options for CIPN. The expert panel approved 17 supportive interventions, most of them were phytotherapeutic interventions including external applications and cryotherapy, hydrotherapy, and tactile stimulation. More than two-thirds of the consented interventions were rated with moderate to high perceived clinical effectiveness in therapeutic use. Conclusions: The evidence of both the review and the expert panel supports a variety of complementary procedures regarding the supportive treatment of CIPN; however, the application on patients should be individually weighed in each case. Based on this meta-synthesis, interprofessional healthcare teams may open up a dialogue with patients interested in non-pharmacological treatment options to tailor complementary counselling and treatments to their needs.