Lee, J., & Oh, H. (2013). Ginger as an antiemetic modality for chemotherapy-induced nausea and vomiting: a systematic review and meta-analysis. Oncology Nursing Forum, 40, 163-170.

To review and evaluate the evidence on the effect of ginger as a modality for management of chemotherapy-induced nausea and vomiting (CINV)

Databases searched were MEDINE, CINAHL, Embase, Cochrane central register, Korean Studies information service system, and dissertation central.

Search keywords were chemotherapy, nausea, vomiting, chemotherapy induced nausea and vomiting, ginger, ginger extract and Zingiver officinale.

The reference lists of retrieved articles also were reviewed.

The inclusion criteria were not specifically stated, but all studies were double blind randomized controlled trials (RCTs).

The exclusion criteria were not stated. However, specific studies that combined ginger with another treatment, did not include sufficient information about the sample and intervention, and examined outcomes per episode of chemotherapy rather than by patient were excluded.

• A total of 11 RCTs were initially identified.
• Reviewers used the Jadad scale to evaluate study quality.

• Five studies were included in the final review.
• Study samples ranged from 17-576 patients.
• Studies involved various cancer types and various chemotherapy emetic potentials.

All patients were in active antitumor treatment.

Three of the studies compared ginger to placebo, and two compared it to metoclopramide or ondansetron. Most of the trials did not use an NK1 in the antiemetic regimen, which is the current recommended guideline. Side effects reported with ginger included drowsiness, sleepiness, dry mouth, thirst, heartburn or restlessness. One study reported bruising, flushing, or rash. Meta-analyses concluded that ginger had no significant effect on control of acute or delayed nausea or vomiting.

Results do not support the use of ginger and did not show an antiemetic effect of ginger for management of CINV.

• The number of studies included in the review was limited.
• The meta analysis had high heterogeneity. 
• Not all studies specified the chemotherapy used and one study combined use with low, moderate, and high emetogenic chemotherapy regimens. 
• Most antiemetic regimens used with ginger did not incorporate current treatment guidelines for CINV.

Ginger does not appear to be effective for the management of CINV.