Efficacy of ginger (Zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: a systematic literature review update and meta-analysis

IntroductionGinger has long been used in traditional medicine for alleviating nausea and vomiting; however, its use as an adjutant therapy in patients undergoing chemotherapy is under-researched. ObjectivesA systematic literature review and meta-analysis was undertaken to evaluate the efficacy of ginger supplementation in the prevention and management of chemotherapy-induced nausea and vomiting.MethodsFive electronic databases were searched from database inception to October 2017. Intervention studies which administered ginger supplementation and a control (placebo or anti-emetic) to adults receiving chemotherapy were included, critically appraised using the Cochrane Risk of Bias tool, and pooled using meta-analysis. Results Seventeen papers were included. Ginger supplementation of any dose or duration had no significant effect on nausea incidence or severity. Ginger administration for >3-days significantly reduced overall vomiting incidence(OR:0.58 [95%CI:0.38-0.90] P=0.01; n=5 studies; I2=74%) and delayed-phase vomiting incidence (OR:0.44 [95%CI:0.25-0.78]P=0.005; n=3 studies; n=239 participants; I2=83%). Sensitivity analysis did not explain the substantial heterogeneity in the pooled outcomes.ConclusionsGinger supplementation for >3-days may improve chemotherapy induced vomiting incidence; however, existing research remains inconsistent. Further research using strong designs, adequate sample sizes and standardized ginger products is warranted prior to routine clinical prescription.