Anti-emetic effect of ginger powder versus placebo as an add-on therapy in children and young adults receiving high emetogenic chemotherapy

• Published in: Pediatric blood & cancer Vol. 56; no. 2; pp. 234 - 238
• Main Authors: Pillai, Anu Kochanujan, Sharma, Kamlesh K, Gupta, Yogendra K., Bakhshi, Sameer
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-02-2011
• Subjects: Adolescent; Antiemetics - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Bone Neoplasms - drug therapy; chemotherapy; Child; children; cisplatin; Cisplatin - adverse effects; Dexamethasone - therapeutic use; Double-Blind Method; Doxorubicin - adverse effects; Female; ginger; Humans; Male; nausea; Nausea - chemically induced; Nausea - prevention & control; oncology; Ondansetron - therapeutic use; Phytotherapy - methods; Plant Roots; Sarcoma - drug therapy; vomiting; Vomiting - chemically induced; Vomiting - prevention & control; Young Adult; young adults; Zingiber officinale
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.22778

Purpose
Chemotherapy‐induced nausea and vomiting (CINV) are major adverse effects of chemotherapy. Ginger has been used in postoperative and pregnancy‐induced nausea and vomiting. Data on its utility in reducing CINV in children and young adults are lacking.
Patients and Methods
Sixty chemotherapy cycles of cisplatin/doxorubicin in bone sarcoma patients were randomized to ginger root powder capsules or placebo capsules as an additional antiemetic to ondensetron and dexamethasone in a double‐blind design. Acute CINV was defined as nausea and vomiting occurring within 24 hr of start of chemotherapy (days 1–4) and delayed CINV as that occurring after 24 hr of completion of chemotherapy (days 5–10). CINV was evaluated as per Edmonton's Symptom Assessment Scale and National Cancer Institute criteria respectively.
Results
Acute moderate to severe nausea was observed in 28/30 (93.3%) cycles in control group as compared to 15/27 (55.6%) cycles in experimental group (P = 0.003). Acute moderate to severe vomiting was significantly more in the control group compared to the experimental group [23/30 (76.7%) vs. 9/27 (33.33%) respectively (P = 0.002)]. Delayed moderate to severe nausea was observed in 22/30 (73.3%) cycles in the control group as compared to 7/27 (25.9%) in the experimental group (P < 0.001). Delayed moderate to severe vomiting was significantly more in the control group compared to the experimental group [14/30 (46.67%) vs. 4/27 (14.81%) (P = 0.022)].
Conclusion
Ginger root powder was effective in reducing severity of acute and delayed CINV as additional therapy to ondensetron and dexamethasone in patients receiving high emetogenic chemotherapy (ClinicalTrials.gov identifier: NCT00940368). Pediatr Blood Cancer 2011;56:234–238. © 2010 Wiley‐Liss, Inc.