Non-pharmacological interventions for side effects of antineoplastic chemotherapy prioritized by patients: systematic review

Highlights This systematic review represents the standard of evidence used to describe non-pharmacological interventions and alternative therapies to manage antineoplastic chemotherapy's side effects. The secondary symptoms of antineoplastic chemotherapy were a priority for patients and caregivers, who identified specific non-pharmacological interventions for each prioritized symptom. The need for standardizing interventions and outcome assessment criteria is highlighted, which would facilitate the development of primary studies and their inclusion in systematic reviews. The need for studies to evaluate the effect and safety of non-pharmacological interventions for the care of patients diagnosed with cancer is emphasized. Introduction: Different non-pharmacological interventions have been studied to manage symptoms derived from chemotherapy, but their effectiveness is unknown. Objective: To describe non-pharmacological interventions for managing symptoms secondary to antineoplastic chemotherapy in adults. Materials and Methods: Systematic review of analytical experimental and observational studies (2021 to 2023). The studies were selected, and data was extracted in parallel. Discrepancies were resolved with a third reviewer. The risk of bias was assessed using the Risk of Bias (RoB) tool and The Newcastle-Ottawa Scale (NOS). The literature was synthesized descriptively based on prioritized outcomes. Results: The prioritized outcomes were neutropenia, pain, neuropathy, nausea, vomiting, alopecia, anorexia, and sleep disorders. Out of 7520 references found, 62 were included for analysis. Acupressure showed a possible effect in controlling symptoms such as nausea and vomiting. The intervention with cold on the scalp showed differences in the stages of alopecia severity. Other interventions showed heterogeneity. Discussion: Non-pharmacological interventions have been widely described in observational and experimental studies in the control of side effects of chemotherapy; however, there is homogeneity and a high risk of bias. Conclusion: Acupressure, muscle massage, music therapy, foot baths, and other interventions have been studied for nausea, vomiting, sleep disorders, neutropenia, alopecia, anorexia, pain, and neuropathy as secondary symptoms prioritized by patients. It is necessary to standardize both the interventions and how measure the outcomes. How to cite this article: Gómez-Neva María Elizabeth, Pulido Ramirez Edwin, Ibañez Rodriguez Leidy Johana, C