Prevalence and Study-Level Predictors of Chronic Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis

Ryan S D’Souza,1 Savannah Whitfield,1 Nasir Hussain,2 Anuj Bhatia,3 Dylan W Banks,4 Jason Parmar,5 Johana Klasova,1 Evan Mizerak,6 Larry J Prokop,7 Yeng F Her11Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA; 2Department of Anesthesiology, The Ohio State Wexner Medical Center, Columbus, OH, USA; 3Department of Anesthesia and Pain Management, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada; 4Department of Physical Medicine and Rehabilitation, NYU Langone, New York City, NY, USA; 5Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA; 6Mayo Clinic Alix School of Medicine, Rochester, MN, USA; 7Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USACorrespondence: Ryan S D’Souza, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA, Tel +1 (507)-284-9696, Fax +1 507-266-7732, Email dsouza.ryan@mayo.eduIntroduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating adverse effect of neurotoxic chemotherapy agents. Despite its substantial global burden, the prevalence of chronic CIPN (persisting for ≥ 3 months after completion of chemotherapy) remains uncertain. We aimed to estimate the global prevalence of chronic CIPN and assess variations based on chemotherapy regimen, cancer type, geographic region, and human development index (HDI).Methods: A systematic search of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus was conducted from database inception to May 2025. A random-effects model with Freeman-Tukey transformation was used for meta-analysis. The primary outcome was the global prevalence of chronic CIPN. Subgroup analysis explored prevalence by time since chemotherapy completion, geographic region, chemotherapy regimen, cancer type, and study design.Results: A total of 197 studies from 36 countries (72,794 patients who received chemotherapy, 26,258 with chronic CIPN) were included. The pooled global prevalence of chronic CIPN was 44.50% (95% CI 40.77– 48.25). Subgroup analyses revealed significant variation by geographic region, chemotherapy class, and cancer type. Chronic CIPN prevalence was 54.37% (95% CI 48.24– 60.45) at 3– 12 months post-chemotherapy, 37.12% (95% CI 30.15– 44.26) at 12– 24 months post-chemotherapy, and 40.36% (95% CI 34.72– 46.08) at ≥ 24 months post-chemotherapy.Conclusion: Chronic CIPN affects a substantial proportion of cancer survivors, with prevalence influenced by time since completion of chemotherapy, geographic region, chemotherapy type, and cancer type. These findings highlight the need for targeted surveillance, prevention, and management, particularly for high-risk populations.Keywords: chemotherapy-induced peripheral neuropathy, peripheral neuropathy, epidemiology, public health, prevalence, systematic review, meta-analysis