Topical herbal medicine as treatment for chemotherapy-induced peripheral neuropathy: a systematic review of randomized controlled trials.

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 ( 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.