Frontiers in oncology · 2026
Topical herbal medicine as treatment for chemotherapy-induced peripheral neuropathy: a systematic review of randomized controlled trials.
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Shao Carrie, Shao Cassie, Haggarty Andrew, Yang Mingxiao, Bao Ting
Аннотация
INTRODUCTION: Chemotherapy-induced peripheral neuropathy (CIPN) is a common neurological complication of cancer treatment that worsens function and quality of life. Topical herbal medicines are increasingly used as localized interventions for neuropathic symptoms; however, their clinical efficacy remains uncertain. This systematic review evaluated the effectiveness of topical herbal formulations for CIPN in cancer populations.
METHODS: We systematically searched Scopus, MEDLINE (Ovid), CINAHL, and Cochrane CENTRAL for randomized controlled trials assessing the use of topical herbal formulations in adults with CIPN. Outcomes included validated measures of CIPN pain, overall severity, sensory function, and adverse events. Risk of bias was assessed using the Cochrane Risk of Bias tool implemented in RevMan 5.3, and all procedures were conducted in accordance with PRISMA guidelines.
RESULTS: Five trials involving 201 participants were included, with an overall moderate risk of bias due to limited blinding and underpowered sample sizes. In breast cancer patients, henna vs. standard care significantly improved the overall severity of oxaliplatin-induced peripheral neuropathy, as measured by the CIPN Assessment Tool (p < 0.001), with significant reductions in sensory and functional subdomain scores. In a mixed-cancer population, Costus sp. oil vs. placebo significantly reduced neuropathic pain intensity, as measured by the Visual Analog Scale (VAS) (p = 0.001), and improved Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT/GOG-Ntx) scores (p = 0.028). Trials evaluating ajwain cream, Citrullus colocynthis oil, and a multi-compound essential oil formulation did not demonstrate statistically significant improvements in CIPN severity, pain, or quality of life compared with placebo. None of the included studies incorporated quantitative sensory or functional testing. All interventions were well tolerated, with only mild localized skin reactions reported.
DISCUSSION: Despite modest benefits from certain herbal treatments in reducing CIPN pain and sensory symptoms, current evidence is limited by small sample sizes, methodological heterogeneity, and the lack of objective outcome measures. Rigorous, adequately powered RCTs with objective CIPN measurements are needed.
METHODS: We systematically searched Scopus, MEDLINE (Ovid), CINAHL, and Cochrane CENTRAL for randomized controlled trials assessing the use of topical herbal formulations in adults with CIPN. Outcomes included validated measures of CIPN pain, overall severity, sensory function, and adverse events. Risk of bias was assessed using the Cochrane Risk of Bias tool implemented in RevMan 5.3, and all procedures were conducted in accordance with PRISMA guidelines.
RESULTS: Five trials involving 201 participants were included, with an overall moderate risk of bias due to limited blinding and underpowered sample sizes. In breast cancer patients, henna vs. standard care significantly improved the overall severity of oxaliplatin-induced peripheral neuropathy, as measured by the CIPN Assessment Tool (p < 0.001), with significant reductions in sensory and functional subdomain scores. In a mixed-cancer population, Costus sp. oil vs. placebo significantly reduced neuropathic pain intensity, as measured by the Visual Analog Scale (VAS) (p = 0.001), and improved Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT/GOG-Ntx) scores (p = 0.028). Trials evaluating ajwain cream, Citrullus colocynthis oil, and a multi-compound essential oil formulation did not demonstrate statistically significant improvements in CIPN severity, pain, or quality of life compared with placebo. None of the included studies incorporated quantitative sensory or functional testing. All interventions were well tolerated, with only mild localized skin reactions reported.
DISCUSSION: Despite modest benefits from certain herbal treatments in reducing CIPN pain and sensory symptoms, current evidence is limited by small sample sizes, methodological heterogeneity, and the lack of objective outcome measures. Rigorous, adequately powered RCTs with objective CIPN measurements are needed.