Evaluation of intervention to prevent hypomagnesemia in cervical cancer patients receiving combination cisplatin and radiation treatment.
OBJECTIVE
The purpose of this study was to evaluate the impact of increasing the magnesium (Mg(2+)) supplementation in the pre- and posthydration of patients receiving cisplatin plus radiation (CisXRT) to prevent chemotherapy-induced hypomagnesemia (CIH) events.


METHODS
The study was conducted on newly diagnosed cervical cancer patients receiving CisXRT. The first prospective intervention to prevent CIH was to increase the pre- and posthydration Mg(2+) from 1 to 2 g. After completion of the first intervention, the analysis demonstrated the persistent occurrence of CIH on cycle 3, and later, a second intervention was implemented to increase Mg(2+) to 3 g in the pre- and posthydration. Patients that failed to complete at least five cycles or received cisplatin in combination with another chemotherapy regimen were excluded from the study. Baseline group included 70 patients that had received CisXRT prior to any changes in magnesium supplementation.


RESULTS
There were 62.8% (44/70) and 32.6% (22/70) of patients with episodes of CIH in the baseline and first intervention groups, respectively (P = 0.007). In the second intervention group, a 49.6% decrease in the total number of episodes compared to control group was observed. Patients in the second intervention group showed a 100% improvement incidence of persistent CIH over the two other cohorts (P = 0.001).


CONCLUSIONS
The increase of Mg(2+) to 2 g for the initial two cycles and then to 3 g with the third cycle of CisXRT therapy prevented episodes of CIH and decreased associated treatment delays.
Hunter
Rodney J
RJ
Division of Pharmacy, The University of Texas M.D. Anderson Cancer Center, CPB6.3244, 1155 Herman Pressler, Unit 1362, Houston, TX 77230, USA.
Pace
Makala B
MB
Burns
Kimberly A
KA
Burke
Catherine C
CC
Gonzales
Deborah A
DA
Webb
Nicki F
NF
Levenback
Charles F
CF
Jhingran
Anuja
A
Parker
Crystal
C
Munsell
Mark F
MF
Smith
Judith A
JA
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008274:Magnesium / Q000008:administration & dosage; D008275:Magnesium Deficiency / Q000139:chemically induced / Q000517:prevention & control*; D008875:Middle Aged; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy*
D000970:Antineoplastic Agents; D008274:Magnesium; D002945:Cisplatin