Systematic Review of the Effectiveness of Complementary and Alternative Medicine on Nausea and Vomiting in Children With Cancer.

Children undergoing cancer treatment often experience severe nausea and vomiting, even when taking anti-nausea medications. In fact, more than 40% of pediatric cancer patients continue to suffer from these symptoms despite standard drug treatments. Researchers conducted a systematic review of 19 studies to determine whether complementary and alternative medicine approaches could help control these distressing side effects.

The review examined various non-drug therapies including acupuncture, acupressure, aromatherapy, hypnosis, massage, relaxation techniques, art therapy, and educational interventions. Among these approaches, three showed the most promise: acupuncture, hypnosis, and massage therapy appeared to improve nausea and vomiting in children with cancer.

However, the researchers found significant limitations in the quality of the studies reviewed. Sixteen of the 19 studies had high risk of bias, meaning their results may not be reliable. Some studies reported adverse events (34 total were documented), and some children or their parents chose to withdraw from the studies. The most common reason for dropping out was refusal to continue from patients or their guardians.

What this means for families: While acupuncture, hypnosis, and massage show potential benefits for managing chemotherapy-related nausea and vomiting in children, the current evidence is not strong enough to make definitive recommendations. These therapies may be worth discussing with your child's oncology team as part of a comprehensive symptom management plan, especially if standard medications aren't providing adequate relief. More high-quality research is needed to confirm these findings and establish clear safety guidelines for pediatric cancer patients. If considering acupuncture for your child, seek a licensed practitioner with experience treating pediatric patients.

This systematic review analyzed 19 randomized controlled trials examining complementary and alternative medicine interventions for chemotherapy-induced nausea and vomiting in pediatric oncology patients. The review searched 10 databases and assessed bias using the Cochrane risk-of-bias tool. Interventions included acupuncture, acupressure, aromatherapy, hypnosis, massage, cognitive distraction/relaxation, creative arts therapy, psychoeducation, and combined approaches.

Key findings: Acupuncture, hypnosis, and massage demonstrated therapeutic benefits for nausea and vomiting reduction. However, 16 of 19 studies showed high risk of bias, significantly limiting evidence quality. Fifteen trials reported intervention adherence data, while only 7 monitored adverse events (34 total documented). Common dropout reasons included patient/guardian refusal.

Clinical takeaway: Current evidence is insufficient to definitively support CAM effectiveness, feasibility, or safety for pediatric chemotherapy-induced nausea and vomiting. While acupuncture, hypnosis, and massage show promise, methodological limitations prevent robust clinical recommendations. Practitioners should counsel patients that more rigorous research is needed before these modalities can be considered evidence-based adjuncts to standard antiemetic protocols in pediatric oncology.