The Use of Complementary and Integrative Medicine in Combination With Pharmacological Antiemetics to Address Chemotherapy-Induced Nausea and Vomiting in Pediatric Oncology: A Scoping Review.

Abstract

Background: Chemotherapy is a common treatment in childhood cancer but causes significant side effects, among the most notable being nausea and vomiting, known as chemotherapy-induced nausea and vomiting (CINV). Pharmacological antiemetics and complementary and integrative medicine (CIM) have been studied separately to manage CINV, but a gap exists in understanding their use together. We aimed to investigate the potential multimodal effects of CIM and pharmacological antiemetics on CINV in pediatric oncology patients undergoing chemotherapy. Method: Systematic searches were conducted in four databases to identify studies evaluating the efficacy of CIM in combination with pharmacological antiemetics in patients ages 0-21 with cancer undergoing chemotherapy. Relevant data were extracted from each study and evaluated. Results: Eighteen sources examining CIM therapies in three distinct categories (herbal, physical, and psychological) were identified. Three of four herbal interventions yielded significant results, all of which implemented oral ginger. Physical interventions included manual and wristband acupressure, auricular acupuncture, and needle and laser acupuncture. Significant results were found in only four of these 10 studies. Among psychological interventions, two of four yielded significant results. Discussion: There is no clear evidence of benefit from CIM therapies in addition to pharmacological antiemetics to better control CINV. However, this review provides support and direction for future research to examine potential effects. Complementary therapies generally have little potential for harm, are relatively low cost, and low burden. Therefore, if there is a perceived benefit for patients and families, complementary and integrative therapies should be considered.