Vitamin D status and chemotherapy-induced peripheral neuropathy in patients with cancer: a systematic review with exploratory quantitative synthesis.
Juncheng Wei, Chuyue Chang, Mengfei Li et al.
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In 30 seconds
This systematic review with exploratory quantitative synthesis assessed whether serum or plasma 25-hydroxyvitamin D status was associated with chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving neurotoxic anticancer therapy. Fourteen records contributed evidence. In exploratory adjusted pooling of two studies, low vitamin D status was associated with higher odds of any CIPN (common-effect OR 2.76, 95% CI 1.70-4.48; random-effects OR 3.36, 95% CI 1.20-9.43). The authors considered the findings hypothesis-generating, given the small number of studies, substantial heterogeneity, and generally high or very high risk of bias.
Key findings
- For any CIPN, two-study adjusted pooling yielded a common-effect OR of 2.76 (95% CI 1.70-4.48; I 2 70.5%).
- For severe CIPN, two-study adjusted pooling yielded a common-effect OR of 1.81 (95% CI 1.32-2.49; I 2 92.4%); the random-effects OR was 2.94 (95% CI 0.63-13.73).
- Low vitamin D status may be associated with greater CIPN risk or severity, particularly when measured before treatment or at baseline.
Why it matters
CIPN is an important toxicity of neurotoxic anticancer therapy, and the review identifies vitamin D status as a possible correlate of its risk or severity. The findings may help frame future research into factors associated with CIPN, but substantial heterogeneity and bias mean the pooled estimates should not be treated as confirmatory evidence.
What to keep in mind
Only two studies contributed to each exploratory pooled estimate; heterogeneity was substantial, and most evidence had high or very high risk of bias.