title: Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients.
abstract: OBJECTIVE
  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.
authors.affiliation: Departments of Dermatology, University of Rochester Medical Center, 601 Elmwood Ave, Box 697, Rochester, NY 14642, USA. julie_ryan@urmc.rochester.edu
authors.forename: Julie L
authors.initials: JL
authors.lastname: Ryan
authors.forename: Charles E
authors.initials: CE
authors.lastname: Heckler
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Roscoe
authors.forename: Shaker R
authors.initials: SR
authors.lastname: Dakhil
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kirshner
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Flynn
authors.forename: Jane T
authors.initials: JT
authors.lastname: Hickok
authors.forename: Gary R
authors.initials: GR
authors.lastname: Morrow
mesh_terms: D000932:Antiemetics / Q000008:administration & dosage / Q000302:isolation & purification / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D020939:Zingiber officinale / Q000737:chemistry*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy; D008517:Phytotherapy; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*; D014840:Vomiting, Anticipatory / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D058831:Serotonin 5-HT3 Receptor Antagonists