Dietary agents in the prevention of radiation-induced nausea and vomiting (RINV): review addressing the scientific observations, benefits, lacunae and future direction

Abstract

Purpose

Radiation-induced Nausea and Vomiting (RINV) is an important side effect and conservative estimates are that 50–80% of the patients undergoing curative radiotherapy (RT) will experience some sought of retching, nausea, and/or vomiting during the course of their treatment. Conventionally, antiemetic drugs like the 5-hydroxytryptamine receptor antagonists and steroids are the mainstay of treatment. However, the use of these agents, especially steroids, can cause side effects and thereby negate the proposed benefits. The antiemetic effects of Centella asiatica (Indian pennywort), Hippophae rhamnoides (Sea buckthorn), oil of Mentha spicata (Spearmint) and the rhizomes of Zingiber officinale (ginger) have been addressed.

Conclusions

Results indicate that Indian pennywort, Sea buckthorn, Spearmint oil and ginger are beneficial in mitigating RINV. Also, of the four plants investigated in preclinical models of study, mint oil and ginger seem to be more useful and merit structured systematic translational studies to ascertain the benefit of these two agents.

Keywords:

• Radiation-induced nausea and vomiting (RINV)
• Centella asiatica
• Hippophae rhamnoides
• Mentha spicata
• Zingiber officinale

Acknowledgments

The respective authors would like to thank the Director, Mangalore Institute of Oncology, Mangalore and Former Directors, INMAS and Director, DIPAS, Delhi for providing necessary support and encouragement. The work on CTA was done while one of the authors (Dr Rajesh Arora) was affiliated with INMAS, Delhi. Dr Shamprasad Varija Raghu is grateful to the DBT-Ramalingaswami Fellowship. The authors thank their respective departmental members for their support.

Disclaimer

This academic review paper reflects the personal view(s) of the authors and should not be construed to reflect the views of the Mangalore Institute of Oncology, Mangalore or Govt. of India or the Ministry of Defence/DRDO or any other institution(s)/agency(ies) whatsoever. This article does not include any sensitive or classified information and is purely of academic and research interest.

Disclosure statement

The authors declare no competing interests.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Princy Louis Palatty

Dr Princy Louis Palatty, MD, Ph.D. is Professor and head of department of Pharmacology at Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, India.

Dhanya Sacheendran

Dr Dhanya Sacheendran, MD, is Assistant Professor in Pharmacology at Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, India.

Shamprasad Varija Raghu

Dr Shamprasad Varija Raghu Ph.D. is Associate Professor at Division of Neuroscience, Yenepoya Research Center, Yenepoya (Deemed to be University), Deralakatte, Mangalore, Karnataka, India 575018.

Rajesh Arora

Dr Rajesh Arora is Scientist ‘G’ and Associate Director with the Defense Research and Development Organization at 4Institute of Nuclear Medicine and Allied Sciences, Delhi, India

Suresh Rao

Dr Suresh Rao MD, is Head of Radiation Oncology at Mangalore Institute of Oncology Mangalore, India

Manjeshwar Shrinath Baliga

Dr Manjeshwar Shrinath Baliga Ph.D. is Head of Research at Mangalore Institute of Oncology Mangalore, India