Effects of Topical Capsaicin for Chemotherapy-Induced Peripheral Neuropathy (CIPN) Prophylaxis in Oxaliplatin-Treated Cancer Patients: A Double-Blind Randomized Clinical Trial

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting adverse effect of oxaliplatin treatment that significantly impacts patients’ quality of life. This study investigated whether topical capsaicin could prevent CIPN progression. Materials and Methods: In this randomized, double-blind, placebo-controlled trial, adult cancer patients receiving oxaliplatin chemotherapy were assigned to either 65% capsaicin cream or placebo, applied twice daily for 6 weeks. Neuropathy was assessed using the Common Terminology Criteria for Adverse Events version-5 scale at baseline, 3 weeks, and 6 weeks. Results: Among 76 study completers, the capsaicin group showed significantly lower neuropathy grades compared to controls (P = 0.001) and higher likelihood of experiencing mild versus moderate-severe symptoms. Significant differences in neuropathy scores were observed between weeks 2 and 3 in the capsaicin group only (P = 0.009). Conclusions: Initial findings suggest topical capsaicin may provide neuroprotective effects against oxaliplatin-induced peripheral neuropathy. While these results indicate potential benefits for cancer patients’ quality of life, larger multicenter trials are needed to confirm efficacy across diverse populations and establish capsaicin’s role as a prophylactic intervention for CIPN.

Keywords

• capsaicin
• drug therapy
• oxaliplatin
• peripheral nervous system diseases