Efficacy of Ginger (Zingiber officinale) in Ameliorating Chemotherapy-Induced Nausea and Vomiting and Chemotherapy-Related Outcomes: A Systematic Review Update and Meta-Analysis

Published:September 10, 2019DOI:https://doi.org/10.1016/j.jand.2019.06.009

      Abstract

      Background

      Ginger has been proposed as an adjuvant treatment for chemotherapy-induced nausea and vomiting.

      Objective

      The aim of this systematic review with meta-analyses is to evaluate, in adult cancer patients receiving chemotherapy, the effects of ginger supplementation dose and duration on the incidence, duration, and severity of chemotherapy-induced nausea and vomiting and outcomes related to chemotherapy-induced nausea and vomiting (eg, quality of life and fatigue), compared with placebo or standard antiemetic medication.

      Method

      Five electronic databases were searched from database inception to April 2018. The quality of evidence was appraised with the Cochrane Risk of Bias tool and Grading of Recommendations, Assessment, Development, and Evaluation level. Data were pooled using Revman software.

      Results

      Eighteen articles were analyzed. The likelihood of acute vomiting was reduced by 60% with ginger supplementation ≤1 g/day for duration >3 days, compared with control groups (odds ratio 0.4, 95% CI 0.17 to 0.81; P=0.01; n=3 studies; n=3 interventions; n=301 participants; I2=20%; Grading of Recommendations, Assessment, Development, and Evaluation level: Moderate). The likelihood of fatigue was reduced by 80% with ginger supplementation of any dose for duration <3 days (odds ratio 0.2, 95% CI, 0.03 to 0.87; P=0.03; n=1 studies; n=2 interventions; n=219 participants; I2=0%; Grading of Recommendations, Assessment, Development, and Evaluation level: Low). No statistically significant association was found between ginger and likelihood of overall or delayed vomiting, likelihood or severity of nausea, or other outcomes related to chemotherapy-induced nausea and vomiting.

      Conclusions

      Ginger supplementation might benefit chemotherapy-induced vomiting as well as fatigue. Due to clinical heterogeneity, this systematic review update found no association between ginger and chemotherapy-induced nausea and other chemotherapy-induced nausea and vomiting-related outcomes. The results of this systematic review and meta-analysis provide a rationale for further research with stronger study designs, adequate sample sizes, standardized ginger products, and validated outcome measures to confirm efficacy of ginger supplementation and optimal dosing regimens.

      Keywords

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      Biography

      M. Crichton is a research dietitian and a PhD candidate, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.

      Biography

      S. Marshall is a senior post-doctoral research fellow, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.

      Biography

      W. Marx is an honorary adjunct research fellow, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia, and Deakin University, Food & Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia.

      Biography

      A. L. McCarthy is a professor of nursing, School of Nursing, University of Auckland, Auckland, New Zealand, and Division of Cancer Services, Princess Alexandra Hospital, Queensland, Australia.

      Biography

      E. Isenring is a professor, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia, and Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.