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.
Article info
Publication history
Published online: September 10, 2019
Accepted:
June 12,
2019
Received:
July 23,
2018
Footnotes
Supplementary materials: Tables 1, 2, 4, 5, and 7, and Figures 1 and 4 through 23, and are available at www.jandonline.org.
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was conducted as part of the Supplemental Prophylactic Intervention for Chemotherapy-Induced Nausea and Emesis trial, which was supported by a Cancer Council Queensland Research Project Grant (no. APP1126733). Cancer Council Queensland had no input to the study design, implementation, or analysis and reporting of results.
The study protocol was registered with the International Prospective Register of Systematic Reviews (no. CRD42017077022).
Identification
Copyright
© 2019 by the Academy of Nutrition and Dietetics.
