Ginger (Zingiber Officinale) Reduces Acute Chemotherapy-Induced Nausea: A URCC CCOP Study of 576 Patients

Support Care Cancer. 2012 Jul;20(7):1479-89. doi: 10.1007/s00520-011-1236-3. Epub 2011 Aug 5.

Abstract

Purpose: Despite the widespread use of antiemetics, nausea continues to be reported by over 70% of patients receiving chemotherapy.

Methods: In this double blind, multicenter trial, we randomly assigned 744 cancer patients to four arms: 1) placebo, 2) 0.5 g ginger, 3) 1.0 g ginger, or 4) 1.5 g ginger. Nausea occurrence and severity were assessed at a baseline cycle and the two following cycles during which patients were taking their assigned study medication. All patients received a 5-HT(3) receptor antagonist antiemetic on Day 1 of all cycles. Patients took three capsules of ginger (250 mg) or placebo twice daily for 6 days starting 3 days before the first day of chemotherapy. Patients reported the severity of nausea on a 7-point rating scale ("1" = "Not at all Nauseated" and "7" = "Extremely Nauseated") for Days 1-4 of each cycle. The primary outcomes were to determine the dose and efficacy of ginger at reducing the severity of chemotherapy-induced nausea on Day 1 of chemotherapy.

Results: A total of 576 patients were included in final analysis (91% female, mean age = 53). Mixed model analyses demonstrated that all doses of ginger significantly reduced acute nausea severity compared to placebo on Day 1 of chemotherapy (p = 0.003). The largest reduction in nausea intensity occurred with 0.5 g and 1.0 g of ginger (p = 0.017 and p = 0.036, respectively). Anticipatory nausea was a key factor in acute chemotherapy-induced nausea (p < 0.0001).

Conclusions: Ginger supplementation at a daily dose of 0.5 g-1.0 g significantly aids in reduction of the severity of acute chemotherapy-induced nausea in adult cancer patients.

Publication types

  • Clinical Trial, Phase II
  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antiemetics / administration & dosage
  • Antiemetics / isolation & purification
  • Antiemetics / therapeutic use*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Ginger / chemistry*
  • Humans
  • Male
  • Middle Aged
  • Nausea / chemically induced
  • Nausea / prevention & control*
  • Neoplasms / drug therapy
  • Phytotherapy*
  • Serotonin 5-HT3 Receptor Antagonists / therapeutic use
  • Severity of Illness Index
  • Treatment Outcome
  • Vomiting / chemically induced
  • Vomiting / prevention & control*
  • Vomiting, Anticipatory / prevention & control

Substances

  • Antiemetics
  • Antineoplastic Agents
  • Serotonin 5-HT3 Receptor Antagonists