CHEMOTHERAPY INDUCED NAUSEA AND VOMITING;

EFFICACY OF ADDING GINGER TO STANDARD THERAPY AS PROPHYLAXIS FOR CHEMOTHERAPY INDUCED NAUSEA AND VOMITING (CINV) IN CANCER PATIENTS.

Abstract

Background: Ginger has long been used as an antiemetic herb in various systems for traditional medicine. However, lack of data on its utility in preventing chemotherapy induced vomiting prevents us from reaching any definite statement. Objectives: To determine the effect of prophylactic use of ginger in decreasing the delayed chemotherapy induced vomiting, when added as an add on therapy to the standard antiemetic treatment in patients receiving highly emetogenic chemotherapy. Study Design: Randomized control trial. Setting: Department of Medical Oncology, Jinnah Hospital Lahore. Period: July 2014 and January 2016. Materials and Methods: A total of 90 patients were selected and randomly allocated into two groups, A and B, having 45 patients each. Patients in both groups received highly emetogenic chemotherapy regimens. For prophylaxis of CINV, Group A received olanzapine based standard antiemetic regimen and cap ginger 500 mg per oral TID 3 days prior to chemotherapy and 3 days after chemotherapy and Group B received olanzapine based standard antiemetic regimen only. Observation for frequency and grade of delayed chemotherapy induced vomiting in all cases was done at day 8 of chemotherapy. Results: The mean age of the patients in group A (intervention group) is 44.5±12.8 years and that in group B (standard group) is 41.4±13.9 years. 29 (64.4%) patients in the intervention group had no vomiting at all as compared to the 19(42.2%) patients in standard group. Mild/Grade 1 vomiting was experienced in 6 (13.3%) patients in the intervention group as compared to 9 (20.0%) patients in the standard arm. There was also a significant reduction in moderate/grade 2 vomiting in intervention arm 7 patients (15.5%) as compared to 11 patients ( 24.4%) in control arm. There was also significant reduction in the severe vomiting that is grade 3 and 4 in group A with the use of ginger capsulesas grade 3 vomiting was observed in only 6.6%versus 15.5% ptients, while none had grade 4 vomiting in group A compared to one patient (2.2%) in group B. Conclusion: Significant decrease in delayed chemotherapy induced vomiting was achieved in patients who were treated with standard antiemetic regimen plus ginger than those treated with standard antiemetic regimen alone, in patients receiving highly emetogenic chemotherapy. So the addition of ginger to standard antiemetic regimens is a safe, less expensive and effective additional treatment option.