Physicians’ Practices in the Diagnosis, Management, and Prevention of Chemotherapy-Induced Peripheral Neuropathy at Khartoum Oncology Hospital, Sudan: A Cross-Sectional Study

• Mona M. Taha

  Department of Pharmacy Practice, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan

• Riham M. Hamadouk

  1. Department of Pharmacy Practice, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan. 2. Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Almughtaribeen University, Khartoum, Sudan

• Mohamed Thabit Ahmed

  Department of Pharmacology, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan

• Elmoiz Babekir

  1. Department of Emergency Medicine, Faculty of Medicine, Mashreq University, Khartoum, Sudan. 2. Department of Medicine and Adult Critical Care Medicine, Ibn Sina College for Medical Studies, Jeddah, Saudi Arabia.

• Mohammed Basendowah

  Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

• Alaa Mousli

  Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

• Mohammed Ahmed Zahrani

  Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

• Sultan Almuallem

  Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

• Khalid A. Ateyyah

  College of Medicine, Taibah University, Madinah, Saudi Arabia

• Bashir A. Yousef

  1. Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan. 2. Department of Clinical Pharmacy and Pharmacology, Ibn Sina National College of Medical Studies, Jeddah, Saudi Arabia

  https://orcid.org/0000-0001-7832-4556

Chemotherapy-induced peripheral neuropathy (CIPN) is a clinically important and potentially dose-limiting toxicity associated particularly with neurotoxic anticancer agents. This study assessed physicians' reported practices regarding CIPN assessment, management, and prevention at Khartoum Oncology Hospital, Sudan. A cross-sectional study was conducted from June to December 2025 among physicians involved in anticancer treatment at Khartoum Oncology Hospital. A total-coverage sampling approach was used, whereby all eligible physicians available during the study period were invited to participate. Data were collected using an expert-reviewed and pilot-tested structured questionnaire. Descriptive and inferential statistics were used according to the study objective to analyze the physicians’ responses. A total of 42 physicians participated (response rate: 79.3%); 27 (64.3%) were female, and all were clinical oncologists. Clinical examination was the most frequently reported CIPN assessment approach, used by 32 physicians (76.2%), while 33 (78.6%) reported establishing a baseline assessment before neurotoxic chemotherapy. During chemotherapy, all 42 physicians reported assessing CIPN, and 36 (85.7%) reported assessment before each chemotherapy cycle. When functional nerve impairment developed, 38 (90.5%) reported therapeutic intervention, and 26 (61.9%) considered physical therapy for patients with physical dysfunction. Gabapentin and vitamin B12 were each reported by 38 physicians (90.5%), whereas duloxetine was reported by 4 (9.5%). Only 8 physicians (19.0%) reported using non-pharmacological approaches for prevention and 6 (14.3%) reported pharmacological preventive approaches. In conclusion, physicians reported several appropriate CIPN-related practices, including baseline assessment, monitoring during chemotherapy, and treatment modification when functional impairment developed. However, important evidence-practice gaps were identified in standardized assessment, pharmacological management, prevention, and safety-oriented supportive care. Development of a locally adapted CIPN assessment and management pathway, together with structured professional training, may improve consistency of care.

[1] Tay N, Laakso EL, Schweitzer D, Endersby R, Vetter I, Starobova H. Chemotherapy-induced peripheral neuropathy in children and adolescent cancer patients. Front Mol Biosci 2022; 9: 1015746.

https://doi.org/10.3389/fmolb.2022.1015746

[2] Jordan B, Jahn F, Sauer S, Jordan K. Prevention and Management of Chemotherapy-Induced Polyneuropathy. Breast Care (Basel) 2019; 14(2): 79-84.

https://doi.org/10.1159/000499599

[3] Li Y, Lustberg MB, Hu S. Emerging Pharmacological and Non-Pharmacological Therapeutics for Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy. Cancers (Basel) 2021; 13(4): 766.

https://doi.org/10.3390/cancers13040766

[4] Mattar M, Umutoni F, Hassan MA, et al. Chemotherapy-Induced Peripheral Neuropathy: A Recent Update on Pathophysiology and Treatment. Life (Basel) 2024; 14(8): 991.

https://doi.org/10.3390/life14080991

[5] Knoerl R. CE: Chemotherapy-Induced Peripheral Neuropathy. Am J Nurs 2021; 121(4): 26-30.

https://doi.org/10.1097/01.NAJ.0000742060.56042.e7

[6] Zajączkowska R, Kocot-Kępska M, Leppert W, Wrzosek A, Mika J, Wordliczek J. Mechanisms of Chemotherapy-Induced Peripheral Neuropathy. Int J Mol Sci 2019 20(6): 1451.

https://doi.org/10.3390/ijms20061451

[7] Ali NT, Mohamed AA, Yousef BA. The Incidence of Oxaliplatin-Induced Peripheral Neurotoxicity at Khartoum Oncology Hospital: A Cross-Sectional Survey. Asia Pac J Oncol Nurs 2020; 7(3): 266-272.

https://doi.org/10.4103/apjon.apjon_12_20

[8] Jordan B, Margulies A, Cardoso F, et al. Systemic anticancer therapy-induced peripheral and central neurotoxicity: ESMO-EONS-EANO Clinical Practice Guidelines for diagnosis, prevention, treatment and follow-up. Ann Oncol 2020; 31(10): 1306-1319.

https://doi.org/10.1016/j.annonc.2020.07.003

[9] Hou S, Huh B, Kim HK, Kim KH, Abdi S. Treatment of Chemotherapy-Induced Peripheral Neuropathy: Systematic Review and Recommendations. Pain Physician 2018; 21(6): 571-592.

[10] Bae EH, Greenwald MK, Schwartz AG. Chemotherapy-Induced Peripheral Neuropathy: Mechanisms and Therapeutic Avenues. Neurotherapeutics 2021; 18(4): 2384-2396.

https://doi.org/10.1007/s13311-021-01142-2

[11] Desforges AD, Hebert CM, Spence AL, et al. Treatment and diagnosis of chemotherapy-induced peripheral neuropathy: An update. Biomed Pharmacother 2022; 147: 112671.

https://doi.org/10.1016/j.biopha.2022.112671

[12] Colvin LA. Chemotherapy-induced peripheral neuropathy: where are we now? Pain 2019; 160 Suppl 1(Suppl 1): S1-S10.

https://doi.org/10.1097/j.pain.0000000000001540

[13] Knoerl R, Mazzola E, Hong F, et al. Exploring the impact of a decision support algorithm to improve clinicians' chemotherapy-induced peripheral neuropathy assessment and management practices: a two-phase, longitudinal study. BMC Cancer 2021; 21(1): 236.

https://doi.org/10.1186/s12885-021-07965-8

[14] Hirayama Y, Yoshida Y, Mori M, Tamura K. Effects of the publication of Clinical Guidelines for the Management of Chemotherapy-Induced Peripheral Neuropathy on the Administration Preferences of Oncology Specialists: Japanese Association of Supportive Care in Cancer. Jpn J Clin Oncol 2020; 50(8): 897-902.

https://doi.org/10.1093/jjco/hyaa056

[15] Loprinzi CL, Lacchetti C, Bleeker J, et al. Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update. J Clin Oncol 2020; 38(28): 3325-3348.

https://doi.org/10.1200/JCO.20.01399

[16] Klafke N, Bossert J, Kröger B, et al. Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process. Med Sci (Basel) 2023; 11(1): 15.

https://doi.org/10.3390/medsci11010015

[17] Hao J, Zhu X, Bensoussan A. Effects of Nonpharmacological Interventions in Chemotherapy-Induced Peripheral Neuropathy: An Overview of Systematic Reviews and Meta-Analyses. Integr Cancer Ther 2020; 19: 1534735420945027.

https://doi.org/10.1177/1534735420945027

[18] Selvy M, Pereira B, Kerckhove N, et al. Prevention, diagnosis and management of chemotherapy-induced peripheral neuropathy: a cross-sectional study of French oncologists' professional practices. Support Care Cancer 2021; 29(7): 4033-4043.

https://doi.org/10.1007/s00520-020-05928-6

[19] Hershman DL, Lacchetti C, Dworkin RH, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2014; 32(18): 1941-67.

https://doi.org/10.1200/JCO.2013.54.0914

[20] Abdalla MA, Osman MA, Mohamed AA, Yousef BA. Evaluation of Common Side Effects of Chemotherapy among Cancer Patients in Khartoum Oncology Hospital Ward, 2019. Khartoum Journal of Pharmaceutical Sciences 2020; 1(1): 1-6.

[21] Osman MA, Abdalla MA, Mohamed AA, Yousef BA. Assessment of drug–drug interactions between chemotherapeutic and chronically used medications at Khartoum oncology hospital. Matrix Science Medica 2020; 4(3): 79-84.

https://doi.org/10.4103/MTSM.MTSM_17_20

[22] Kanzawa-Lee G, Krauss JC, Knoerl R. Exploring Chemotherapy-Induced Peripheral Neuropathy Management Practice Patterns Among Oncology Clinicians. Semin Oncol Nurs 2024; 40(5): 151685.

https://doi.org/10.1016/j.soncn.2024.151685

[23] Preti K, Davis ME. Chemotherapy-Induced Peripheral Neuropathy: Assessment and Treatment Strategies for Advanced Practice Providers. Clin J Oncol Nurs 2024; 28(4): 351-357.

https://doi.org/10.1188/24.CJON.351-357

[24] Al-Atiyyat NM, Banifawaz AZ. Oncology nurses' knowledge, practice, and confidence toward chemotherapy-induced peripheral neuropathy in Jordan. Saudi Med J 2018; 39(11): 1158-1163.

https://doi.org/10.15537/smj.2018.11.23303

[25] World Health Organization. WHO handbook for reporting results of cancer treatment. Geneva: World Health Organization; 1979. WHO Offset Publication No. 48.

[26] Seretny M, Currie GL, Sena ES, et al. Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis. Pain 2014; 155(12): 2461-2470.

https://doi.org/10.1016/j.pain.2014.09.020

[27] Knoerl R, Mazzola E, Mitchell SA, et al. Measurement properties of brief neuropathy screening items in cancer patients receiving taxanes, platinums, or proteasome inhibitors. J Patient Rep Outcomes 2021; 5(1): 101.

https://doi.org/10.1186/s41687-021-00377-z

[28] Belloni S, Magon A, Giacon C, Savioni F, Conte G, Caruso R, Arrigoni C. Peripheral Neuropathy Instruments for Individuals with Cancer: A COSMIN-Based Systematic Review of Measurement Properties. Curr Oncol 2024; 31(12): 7828-7851.

https://doi.org/10.3390/curroncol31120577

[29] Kaplow R, Iyere K. Grading chemotherapy-induced peripheral neuropathy in adults. Nursing 2017; 47(2): 67-68.

https://doi.org/10.1097/01.NURSE.0000511823.41645.a1

[30] Sugimoto M, Takagi T, Suzuki R, et al. Drug treatment for chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer. Fukushima J Med Sci 2022; 68(1): 1-10.

https://doi.org/10.5387/fms.2021-32

[31] Kachrani R, Santana A, Rogala B, Pawasauskas J. Chemotherapy-Induced Peripheral Neuropathy: Causative Agents, Preventative Strategies, and Treatment Approaches. J Pain Palliat Care Pharmacother 2020; 34(3): 141-152.

https://doi.org/10.1080/15360288.2020.1734144

[32] Molinares D, Kurtevski S, Zhu Y. Chemotherapy-Induced Peripheral Neuropathy: Diagnosis, Agents, General Clinical Presentation, and Treatments. Curr Oncol Rep 2023; 25(11): 1227-1235.

https://doi.org/10.1007/s11912-023-01449-7

[33] Amarelo A, Mota MCC, Amarelo BLP, Ferreira MC, Fernandes CS. Effects of Physical Exercise on Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis. Pain Manag Nurs 2025; 26(2): 212-221.

https://doi.org/10.1016/j.pmn.2024.12.011

[34] Lavoie Smith EM, Lee M, Scott MR, et al. Alliance A221805: Duloxetine to Prevent Oxaliplatin-Induced Chemotherapy-Induced Peripheral Neuropathy: A Randomized, Double-Blind, Placebo-Controlled Phase II Study. JCO Oncol Adv 2026; 3(1): e2500107.

https://doi.org/10.1200/OA-25-00107

[35] Smith EML, Lee M, Scott MR, et al. Alliance A221805: Duloxetine to Prevent Oxaliplatin-Induced Chemotherapy-Induced Peripheral Neuropathy: A Randomized, Double-Blind, Placebo-Controlled Phase II Study. JCO Oncol Adv 2026; 3(1): e2500107.

https://doi.org/10.1200/OA-25-00107

• PDF

• Original Research Articles

Copyright (c) 2026 Mona M. Taha, Riham M. Hamadouk, Mohamed Thabit Ahmed, Elmoiz Babekir, Mohammed Basendowah, Alaa Mousli, Mohammed Ahmed Zahrani, Sultan Almuallem, Khalid A. Ateyyah, Bashir A. Yousef

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.