Effects of aromatherapy on nausea and vomiting in patients with cancer: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: and purpose: Aromatherapy offers a low-risk solution for effectively managing common nausea and vomiting in cancer patients. This systematic review and meta-analysis aimed to assess its impact on these symptoms to facilitate practical guidelines establishment. METHODS: PubMed, Web of Science, Cochrane Library, MEDLINE, CINAHL, and Embase were searched for articles published until April 30, 2023. Inclusion criteria were randomized controlled trials (RCTs) on the effect of aromatherapy on nausea and vomiting in patients with cancer (age ≥18 years). The effect size was calculated using standardized mean differences (SMDs) with a random effects model. Subgroup analyses, meta-analysis of variance, and meta-regression were performed using the "meta" package in R version 4.0.2. Heterogeneity was assessed using I2 statistics. Sensitivity and publication bias analyses were performed; two reviewers independently assessed risk of bias using Cochrane's risk-of-bias tool 2.0. RESULTS: Twenty-five RCTs across 10 articles revealed that aromatherapy reduced overall nausea and vomiting in patients with cancer with significant efficacy (SMD = -0.81, 95 % confidence interval [CI]: -1.11 to -0.52). Furthermore, aromatherapy reduced nausea (SMD = -0.85, 95 % CI: -1.23 to -0.46) and combined nausea and vomiting (SMD = -1.08, 95 % CI: -1.68 to -0.47), but not vomiting alone (SMD = -0.24, 95 % CI: -1.03 to 0.55). Inhalation and massage yielded positive results, especially in chemotherapy-induced cases; peppermint oil was particularly successful. CONCLUSION: Our findings underscore aromatherapy's value in managing cancer treatment-associated nausea and vomiting. Conclusive evidence on aromatherapy-led nausea reduction is lacking due to limited RCTs; research is warranted for robust conclusions.

Effects of Aromatherapy on Cancer Patients' Sleep and Fatigue: A Systematic Review and Meta-Analysis.

Objective: This study aims at investigating the effectiveness of aromatherapy in enhancing sleep quality and reducing fatigue among cancer patients based on randomized controlled trials (RCTs) with a high level of evidence. Design: A systematic review and meta-analysis. Methods: Two reviewers screened and reviewed the full texts of search results obtained from six English databases and four Korean databases, and they extracted data from the selected studies independently. Risk of bias (RoB) was assessed using the revised Cochrane RoB tool for randomized trials. The review protocol was registered with the International Prospective Register of Systematic Reviews (CRD42021277515). Results: Eleven RCTs were included in this study. Aromatherapy significantly improved sleep quality among cancer patients compared with those in the control groups (routine care, no intervention, and placebo) (standardized mean difference [SMD] = -0.92, 95% confidence interval [CI]: -1.39 to -0.46; p < 0.001, I2 = 89%). However, aromatherapy did not significantly reduce fatigue among such patients (SMD = -0.40, 95% CI: -0.81 to 0.01). The results of the meta-regression confirmed that increased intervention sessions resulted in the enhanced effectiveness of aromatherapy in improving sleep quality among cancer patients (Z = -3.86, p < 0.001). Conclusion: This study showed that aromatherapy significantly improves sleep quality among cancer patients. However, aromatherapy does not significantly reduce fatigue among cancer patients. It is possible that the statistical power of the meta-analysis was weak due to the small number of included studies. Therefore, in future studies, the effects of aromatherapy on fatigue among cancer patients should be assessed further using a larger number of included studies. Further, the effects of aromatherapy should be evaluated with a focus on specific subsets of patients, such as specific cancer diagnoses and specific modalities for cancer treatment.

Bone mineral density change during adjuvant chemotherapy in pediatric osteosarcoma.

PURPOSE: Osteoporosis is currently receiving particular attention as a sequela in survivors of childhood osteosarcoma. The aim of this study was to evaluate bone mineral density (BMD) changes during methotrexate-based chemotherapy in children and adolescents with osteosarcoma. METHODS: Nine patients with osteosarcoma were included in this retrospective study and compared with eight healthy controls. BMD of the lumbar spine and unaffected femur neck of patients was serially measured by dual-energy x-ray absorptiometry (DXA) before and just after chemotherapy and compared with controls. RESULTS: Four patients (44%) showed decreased lumbar spine BMD and seven patients (78%) showed decreased femur neck BMD, while all controls showed increased lumbar and femur BMD (P=0.024 and P=0.023). The femur neck BMD z-scores decreased from -0.49±1.14 to -1.63±1.50 (P=0.032). At the end of therapy, five patients (56%) showed femur neck BMD z-scores below -2.0. CONCLUSION: The bone metabolism is disturbed during therapy in children with osteosarcoma, resulting in a reduced BMD with respect to healthy controls. Since a reduced BMD predisposes to osteoporosis, specific attention and therapeutic interventions should be considered.