Evaluation of intervention to prevent hypomagnesemia in cervical cancer patients receiving combination cisplatin and radiation treatment

• Published in: Supportive care in cancer 2009-09, Vol.17 (9), p.1195-1201
• Main Authors: Hunter, Rodney J., Pace, Makala B., Burns, Kimberly A., Burke, Catherine C., Gonzales, Deborah A., Webb, Nicki F., Levenback, Charles F., Jhingran, Anuja, Parker, Crystal, Munsell, Mark F., Smith, Judith A.
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Cervical cancer; Chemotherapy; Cisplatin - administration & dosage; Cisplatin - adverse effects; Female; Humans; Magnesium - administration & dosage; Magnesium Deficiency - chemically induced; Magnesium Deficiency - prevention & control; Medicine; Medicine & Public Health; Middle Aged; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Prospective Studies; Radiotherapy, Adjuvant - adverse effects; Rehabilitation Medicine; Uterine Cervical Neoplasms - drug therapy
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-008-0574-2

Purpose 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. Materials and 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.