Efficacy of multimodal symptom management strategies for chemotherapy-induced nausea and vomiting in gynecologic cancer: a meta-analysis.

Authors

Weina Zhou, Minfen Chen, Tingting Wang, Liying Zhang

Published in

American journal of cancer research. Volume 16. Issue 8. Pages 3202-3221. Epub Aug 15, 2026.

Abstract

This meta-analysis aimed to evaluate whether multimodal symptom management improves chemotherapy-induced nausea and vomiting (CINV) among patients with gynecologic cancer across acute, delayed, and overall treatment phases. We systematically searched major electronic databases and trial registries for eligible English-language studies from database inception to the final search date. Included studies enrolled female patients with gynecologic malignancies receiving chemotherapy and evaluated multimodal symptom management strategies for CINV control. Two independent researchers screened literature records and extracted data using a standardized form. Risk of bias of included studies were evaluated based on standard evaluation domains. All quantitative analyses were performed with a random-effects model. Dichotomous outcome data were pooled to calculate risk ratios (RRs) and 95% confidence intervals (CIs). Predefined subgroup analyses were conducted for acute, delayed, and overall phases. We assessed statistical heterogeneity via Cochran's Q test and I² statistics, and evaluated publication bias through visual inspection of funnel plots. Multimodal symptom management strategies yielded no significant improvements in overall complete CINV control (RR 1.02, 95% CI: 0.86-1.21), acute complete CINV control (RR 0.96, 95% CI: 0.80-1.15), or delayed complete CINV control (RR 0.94, 95% CI: 0.77-1.14), with low to no statistical heterogeneity across these analyses. Likewise, no significant benefit was observed for overall no-vomiting events (RR 1.46, 95% CI: 0.75-2.83) or overall no-significant-nausea events (RR 1.59, 95% CI: 0.71-3.54), with substantial heterogeneity detected for both outcomes. Notably, multimodal interventions significantly increased the rates of acute no-vomiting events (RR 1.99, 95% CI: 1.42-2.80) and acute no-significant-nausea events (RR 2.05, 95% CI: 1.43-2.94), with no detectable heterogeneity. Conclusion: Multimodal symptom management strategies offer tangible clinical benefits for acute CINV control in gynecologic cancer patients, especially in the prevention of vomiting and clinically significant nausea. These strategies show no obvious superiority for delayed and overall CINV comprehensive control.

PMID:
42724622
Bibliographic data and abstract were imported from PubMed on 11 Sep 2026.

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