Evaluating Acupuncture for Chemotherapy-Induced Peripheral Neuropathic Pain: A Narrative Review of Clinical Evidence and Mechanistic Perspectives.

BACKGROUND/OBJECTIVES: Despite the high prevalence of chemotherapy-induced peripheral neuropathic pain (CIPNp), its management remains challenging, and reliable preventive strategies are still lacking. Current treatment is largely symptomatic and often provides only modest benefits, as available pharmacological therapies have shown limited and inconsistent efficacy. In this context, acupuncture has been investigated as a non-pharmacological intervention, but the certainty and clinical applicability of the available evidence remain unclear. This critical narrative review examines the clinical evidence, mechanistic plausibility, and current research gaps concerning acupuncture for CIPNp. METHODS: A non-systematic narrative review was conducted with preference given to peer-reviewed articles published in English, including clinical trials, systematic reviews, meta-analyses, clinical guidelines, mechanistic studies, and narrative reviews considered relevant to the objectives. Publications were not selected according to a predefined systematic protocol, and no formal quality assessment, risk-of-bias analysis, or meta-analysis was performed. The extracted information was organized thematically rather than quantitatively. RESULTS: Clinical trials and evidence syntheses suggest that acupuncture may be associated with reductions in pain and sensory symptoms in some patients with CIPN. However, confidence in these findings is limited by small samples sizes, heterogeneous acupuncture protocols, variable comparators and outcome measures, and limited long-term follow-up. Much of the proposed mechanistic rationale derives from animal models or human studies in non-CIPN pain conditions. CONCLUSIONS: Acupuncture may be considered a monitored adjunctive option for selected patients with persistent CIPNp. More rigorous and adequately powered trials are required to determine efficacy, optimal treatment protocols, durability of benefit, and potential treatment-response modifiers.