Effects of Cancer Treatment on Somatosensory and Nociceptive Processing in Children and Adolescents: A Systematic Review.

Chemotherapy-induced peripheral neuropathy remains a major complication in pediatric cancer, with disrupted somatosensory and nociceptive processing being a key aspect. This review synthesizes empirical studies on alterations in somatosensory and nociceptive processing in children and adolescents with cancer. We conducted this review in accordance with PRISMA 2020 guidelines and preregistered it in PROSPERO. A systematic search was performed in MEDLINE, CINAHL, and Web of Science in April 2025. Eligible studies were screened by two independent reviewers and synthesized narratively. Risk of bias was assessed using the Newcastle Ottawa Quality Assessment Scale for Case-Control Studies. Nine studies met the inclusion criteria, all using cross-sectional designs and quantitative sensory testing (QST) or other pain protocols. Overall, findings suggest altered somatosensory processing in this population, with higher mechanical and thermal detection thresholds in patients compared to controls. Findings on nociceptive processing were more heterogeneous, with most studies suggesting unaltered pain sensitivity in the lower pain range and increased sensitivity in the higher pain range, highlighting increased pain vulnerability to more intense pain stimuli following cancer and its treatment. This review reveals a pattern of decreased somatosensory processing and increased nociceptive processing in pediatric patients/survivors with cancer, likely attributable to damage of peripheral nervous tissues as well as central sensitization.