Ginger Relief Chemotherapy Induced Nausea and Vomiting (CINV) in Children: A Randomized Clinical Trial

Background One of the major adverse effects of chemotherapy is chemotherapy induced nausea and vomiting (CINV) which can obviously reduce patients' quality of life. Ginger (Zingiber officinale), an herbal supplement, has been used for centuries for gastrointestinal complaints. Although many surveys have been conducted to find the efficiency of ginger on CINV, its benefit has not been proven yet. We aimed to find ginger's efficiency on pediatric patients throughout their chemotherapy cycles. Materials and Methods: This was a double-blinded, randomized, single institutional, placebo-controlled trial conducted at oncology ward in Aliasghar children's hospital, Tehran, Iran. The study took place between October 2017 and October 2018. We included 49 chemotherapy cycles, 25 cycles for treatment group and 24 cycles for placebo groups. Intervention group took encapsulated ginger which contained 240mg of powdered ginger (Nausophar), and control group took placebo. All patients took the study medication four times per day (every 6h), starting on the first day of chemotherapy until 24h after completion of chemotherapy. Frequency and severity of nausea and vomiting were measured by Edmonton's Symptom Assessment Scale (ESAS) from the first day of chemotherapy until 24h after completion of chemotherapy. Results: The median age of all participants was 13 (IQR=8-14 year-old). Fourteen patients were male (28.6%), and 35 patients were female (71.4%). There were no significant differences in distribution of patients' characteristics in two groups. The frequency and severity of nausea and vomiting were significantly lower in ginger group (p<0.05). Conclusion According to our findings, ginger acts as an efficient antiemetic for pediatric patients. We recommend that ginger be prescribed as well as other antiemetics like Granisetron, with no loss of function.