title: Infusion of calcium and magnesium for oxaliplatin-induced sensory neurotoxicity in colorectal cancer: a systematic review and meta-analysis.
abstract: BACKGROUND
  It is hypothesised that infusion of calcium and magnesium (Ca/Mg) can reduce the occurrence of oxaliplatin-related sensory neurotoxicity. However, more recent data have drawn a controversial picture concerning this topic.
  
  
  METHODS
  A comprehensive literature search was performed using Medline, Embase, Cochrane Library and Google Scholar database up to 1st August 2011. Keywords for the search were: calcium, magnesium and oxaliplatin. The odd ratio (OR) for neurotoxicity and relative risk (RR) for tumour response rate were calculated.
  
  
  RESULTS
  Seven studies (four randomised controlled trials (RCTs) and three cohorts) including a total of 1238 participants met our criteria. Meta-analysis of three RCT studies that reported in National Cancer Institute-Common Toxicity Criteria (NCE-CTC) showed that OR for neurotoxicity of Grade ~2 was not significant (OR 0.47; 95%confidence interval (CI) 0.22-1.00, P homogeneity = .729). The OR was also not significant in All Grades (OR 3.15, 0.32-31.35, P homogeneity = .952) and Grade 3 subgroup (OR 1.64, 0.30-9.00, P homogeneity = .656). No statistically significant difference was observed in RR for tumour response rate. (RR = 0.91, 0.78-1.06, P homogeneity = .33)
  
  
  CONCLUSIONS
  This meta-analysis does not support the hypothesis that infusion of Ca/Mg reduces the occurrence of neurotoxicity in oxaliplatin-treated patients with colorectal cancer measuring with NCE-CTC criteria. On the other hand, our results support the hypothesis that administrations of Ca/Mg do not impair the efficacy of oxaliplatin-based chemotherapy. However, large-scale randomised, controlled clinical trials will be required to confirm these hypotheses.
authors.affiliation: Colorectal Surgery, the First Affiliated Hospital, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 Guangxi, People's Republic of China.
authors.forename: Zhenjie
authors.initials: Z
authors.lastname: Wu
authors.forename: Jun
authors.initials: J
authors.lastname: Ouyang
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: He
authors.forename: Sen
authors.initials: S
authors.lastname: Zhang
mesh_terms: D002118:Calcium / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D008274:Magnesium / Q000008:administration & dosage*; D020258:Neurotoxicity Syndromes / Q000517:prevention & control*; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin; D011984:Sensory Receptor Cells / Q000187:drug effects
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D008274:Magnesium; D002118:Calcium