Meta-analysis of compression therapy for prevention of chemotherapy-induced peripheral neuropathy
A partir d'une revue systématique de la littérature publiée jusqu'en décembre 2024 (7 études, 533 patients), cette méta-analyse évalue l'intérêt d'une thérapie de compression pour prévenir une neuropathie périphérique induite par la chimiothérapie
Objective: To investigate the prophylactic effect of compression therapy against chemotherapy-induced peripheral neuropathy (CIPN) through meta-analytic evaluation.
Methods: Systematically searched PubMed, Embase, Web of Science, Cochrane Library, Scopus, and Chinese databases (CBM, CNKI, Wan fang, VIP) until December 2024. Included studies were RCTs and quasi-experimental designs. Two reviewers independently screened studies, extracted data, and assessed quality using Cochrane RoB 2.0 (RCTs) and JBI tools (quasi-experimental). The primary outcome was the incidence of clinically significant CIPN (CTCAE ≥ Grade 2 or PNQ ≥ Grade D), stratified into sensory and motor subtypes; secondary outcomes included CIPNAT scores and safety. Meta-analysis (RevMan 5.4) used RR (dichotomous) and SMD (continuous), with fixed-/random-effects models based on heterogeneity (I2 < 50% or ≥ 50%). Sensitivity analyses (model substitution, leave-one-out exclusion) and publication bias evaluations (funnel plots, Egger’s regression) were implemented to verify result robustness. Registered on PROSPERO (CRD42024621873).
Results: The meta-analysis incorporated seven studies (four RCTs, three quasi-experimentals), encompassing 533 participants. All trials exclusively evaluated patients receiving paclitaxel-based chemotherapy regimens, with treatment cycles ranging from 12 to 18 weeks. Pooled results demonstrated that compression therapy significantly reduced the incidence of clinically significant CIPN (RR = 0.59, 95%CI (0.43, 0.81), P = 0.001). Protection was observed for both peripheral sensory nerves (RR = 0.33, 95%CI (0.23, 0.48), P < 0.00001) and motor nerves (RR = 0.38, 95%CI (0.26, 0.56), P < 0.00001). Furthermore, compression therapy was associated with improved CIPNAT scores (MD = -36.16, 95%CI (-57.66, -14.66), P = 0.0010). Adverse events were rare, limited to isolated cases of glove-related latex allergy.
Conclusion: Compression therapy exhibits promising preventive effects against paclitaxel-induced CIPN by diminishing its occurrence and demonstrates clinical safety. Nevertheless, considering the methodological limitations of currently available research, future investigations should prioritize well-designed randomized controlled trials to validate findings and establish standardized guidelines for implementing compression-based interventions.
Supportive Care in Cancer , résumé, 2025