Comparative Study of Different Doses of Magnesium sulfate as A Protective Agent in Cisplatin Induced Nephrotoxicity in Patients with Head and Neck Cancer Abstract

Abstract

Background: Head and neck cancer (HNC) are a collection of cancers that develop in the oral cavity, pharynx, larynx, nasal cavity, paranasal sinuses, salivary glands, or head and neck lymph nodes. The purpose of this investigation was to evaluate the potential advantages of magnesium (Mg) in cisplatin-induced nephrotoxicity prevention and to estimate the suitable dosage of Mg for patients had HNC.

Methods: This randomized, controlled, parallel, clinical study involved 100 patients had HNC, managed at Clinical Oncology Department Tanta University Hospital, Tanta, Egypt. According to randomization, patients were divided into 4 equal groups; group 1 (control group) received cisplatin, group 2 (8 Meq Mg) received cisplatin with hydration 8 Meq Mg, group 3 (16 Meq Mg) received cisplatin with hydration 16 Meq Mg and group 4 (24 Meq Mg) received cisplatin with hydration 24 Meq Mg.

Results: Multivariable Cox proportional hazards regression was conducted for variables that showed a significant association in univariable regression. Mg intake still showed better overall survival than group 1 after adjusting for previous smoking effect, where the adjusted HR was 0.361 (95% CI: 0.166 to 0.785; p = 0.010. The risk was still significantly higher among previous smokers compared to non-smokers, even after adjusting for the treatment effect (HR: 2.759; 95% CI: 1.254 to 6.070; p = 0.012).

Conclusions: Mg can be used as a protective agent in cisplatin induced nephrotoxicity as it decreases blood urea nitrogen, serum creatinine and increase eGFR compared to cisplatin alone regimen.