Prophylactic Effect of Premedication with Intravenous Magnesium on Renal Dysfunction in Preoperative Cisplatin-Based Chemotherapy for Esophageal Cancer.


Journal

Oncology
ISSN: 1423-0232
Titre abrégé: Oncology
Pays: Switzerland
ID NLM: 0135054

Informations de publication

Date de publication:
2019
Historique:
received: 07 05 2019
accepted: 07 07 2019
pubmed: 26 9 2019
medline: 18 12 2019
entrez: 26 9 2019
Statut: ppublish

Résumé

Magnesium premedication is reported to have a significant effect on reducing cisplatin-induced nephrotoxicity in several types of cancer. However, the effectiveness of magnesium administration in reducing nephrotoxicity remains unknown in esophageal cancer, especially regarding neoadjuvant therapy. Between January 2017 and January 2019, 105 patients who underwent neoadjuvant chemotherapy followed by surgery were included in this study. Of these patients, 40 received intravenous magnesium premedication (magnesium group), whereas the remaining 65 did not (control group). We investigated the -association between magnesium premedication and chemotherapy-related nephrotoxicity. Baseline characteristics, such as age, body mass index, clinical stage, comorbidity, and pretreatment renal function, were not significantly different -between the magnesium and control groups. Clinical and -pathological responses were similar between the 2 groups. Regarding chemotherapy-related toxicity, there were no significant differences in hematological side effects, such as anemia, thrombopenia, and neutropenia, between both groups. However, nephrotoxicity of grade 2 and higher was significantly less frequent in the magnesium group than in the control group (2.5 vs. 21.5%, p = 0.0026), although there was no significant difference in the incidence of other nonhematological adverse events, such as nausea and diarrhea. Multivariate analysis indicated magnesium premedication and heart disease as independent factors associated with cisplatin-induced nephrotoxicity (p = 0.0026 and p = 0.0424, respectively). We showed that intravenous magnesium premedication exerts a protective effect against renal dysfunction in esophageal cancer patients undergoing neoadjuvant chemotherapy including high-dose cisplatin. Large-scale prospective studies are needed to confirm the effect of magnesium premedication on reducing nephrotoxicity in esophageal cancer patients undergoing neoadjuvant therapy.

Sections du résumé

BACKGROUND BACKGROUND
Magnesium premedication is reported to have a significant effect on reducing cisplatin-induced nephrotoxicity in several types of cancer. However, the effectiveness of magnesium administration in reducing nephrotoxicity remains unknown in esophageal cancer, especially regarding neoadjuvant therapy.
METHODS METHODS
Between January 2017 and January 2019, 105 patients who underwent neoadjuvant chemotherapy followed by surgery were included in this study. Of these patients, 40 received intravenous magnesium premedication (magnesium group), whereas the remaining 65 did not (control group). We investigated the -association between magnesium premedication and chemotherapy-related nephrotoxicity.
RESULTS RESULTS
Baseline characteristics, such as age, body mass index, clinical stage, comorbidity, and pretreatment renal function, were not significantly different -between the magnesium and control groups. Clinical and -pathological responses were similar between the 2 groups. Regarding chemotherapy-related toxicity, there were no significant differences in hematological side effects, such as anemia, thrombopenia, and neutropenia, between both groups. However, nephrotoxicity of grade 2 and higher was significantly less frequent in the magnesium group than in the control group (2.5 vs. 21.5%, p = 0.0026), although there was no significant difference in the incidence of other nonhematological adverse events, such as nausea and diarrhea. Multivariate analysis indicated magnesium premedication and heart disease as independent factors associated with cisplatin-induced nephrotoxicity (p = 0.0026 and p = 0.0424, respectively).
CONCLUSION CONCLUSIONS
We showed that intravenous magnesium premedication exerts a protective effect against renal dysfunction in esophageal cancer patients undergoing neoadjuvant chemotherapy including high-dose cisplatin. Large-scale prospective studies are needed to confirm the effect of magnesium premedication on reducing nephrotoxicity in esophageal cancer patients undergoing neoadjuvant therapy.

Identifiants

pubmed: 31553989
pii: 000501966
doi: 10.1159/000501966
doi:

Substances chimiques

Magnesium I38ZP9992A
Cisplatin Q20Q21Q62J

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

319-326

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Yuto Kubo (Y)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Hiroshi Miyata (H)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan, miyata-hi@mc.pref.osaka.jp.

Keijiro Sugimura (K)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Naoki Shinno (N)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Hajime Ushigome (H)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Yoshitomo Yanagimoto (Y)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Yusuke Takahashi (Y)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Kazuyoshi Yamamoto (K)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Junichi Nishimura (J)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Hiroshi Wada (H)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Hidenori Takahashi (H)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Masayoshi Yasui (M)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Takeshi Omori (T)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Masayuki Ohue (M)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

Masahiko Yano (M)

Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.

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Classifications MeSH