IMPACT OF COGNITIVE-BEHAVIORAL THERAPY ON PAIN AND ASSOCIATED SYMPTOMS IN CANCER SURVIVORS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: A SYSTEMATIC REVIEW OF DIFFERENTIAL EFFECTS ON PAIN, PSYCHOLOGICAL DISTRESS, AND QUALITY OF LIFE

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and debilitating adverse effect of neurotoxic agents, characterized by chronic pain, sensory disturbances, and significant psychological distress, for which effective treatments are limited. Cognitive-Behavioral Therapy (CBT) offers a non-pharmacological approach by targeting the central cognitive-affective mechanisms that modulate pain perception. This systematic review aimed to evaluate the efficacy of CBT compared to control conditions in reducing pain, improving sensory symptoms, functional ability, quality of life, and psychological distress in adult cancer survivors with CIPN. A systematic literature search was conducted following PRISMA guidelines across six electronic databases, resulting in the qualitative synthesis of four studies. The findings demonstrate that CBT consistently produces significant, clinically relevant reductions in neuropathic pain intensity and associated distress, though it has minimal effect on objective sensory deficits. Improvements in function and quality of life were observed as secondary benefits. Critically, the intervention format was a key moderating factor, with therapist-led protocols yielding broader improvements across psychological and quality-of-life domains compared to self-guided programs, which were primarily effective for pain reduction. The therapeutic mechanism was identified as top-down cognitive-affective regulation, involving reduced catastrophic thinking and improved perceived control. In conclusion, CBT is an effective intervention for managing the pain and distress of CIPN, with its benefits being most comprehensive when delivered through a structured, therapist-led format, supporting its integration as a core component of a multimodal management strategy.

Categories: Medicine and Pharmacology, Neuroscience, Oncology, Psychology, Public Health and Epidemiology.