Background: Hypomagnesemia is a known side effect of several antineoplastic agents, but its impact on outcomes of patients with cancer is not well understood. We examined whether magnesium abnormalities affect survival in patients with ovarian cancer who receive chemotherapy containing carboplatin.
Materials and methods: We included patients with advanced ovarian cancer who had undergone surgery and chemotherapy between January 1, 2004, and December 31, 2014, at our institution. Inclusion criteria were age 18 years or older, pathology of high-grade serous carcinoma, first treatment (surgery or chemotherapy) within 60 days of diagnosis, and chemotherapy containing carboplatin. The final cohort consisted of 229 patients. Vital signs and laboratory tests were recorded at baseline and during the treatment course. The associations between magnesium abnormalities (and other clinical characteristics) and survival were analyzed.
Results: The median patient age was 64 years. Higher baseline heart rate (beats per minute; hazard ratio [HR] = 1.02, p = .002) and greater frequency of hypomagnesemia during the treatment course (HR = 1.05, p = .002) were significantly associated with shorter survival independent of completeness of tumor reduction (HR = 1.60, p = .02), and International Federation of Gynecology and Obstetrics stage (HR = 1.63, p = .01).
Conclusion: Baseline heart rate and the frequency of hypomagnesemia episodes during treatment are prognostic of survival for patients with advanced ovarian cancer receiving carboplatin-containing chemotherapy and tumor reductive surgery. Future research is needed for strategies to detect and prevent hypomagnesemia in this patient population.
Implications for practice: Despite standard laboratory tests and intravenous magnesium replacement prior to each cycle of chemotherapy, hypomagnesemia remains a common side effect of platinum-based chemotherapy. This study revealed that frequent occurrence of hypomagnesemia during the course of treatment including carboplatin-containing chemotherapy and tumor reductive surgery was strongly predictive of shorter survival in patients with advanced ovarian cancer. Strategies to effectively mitigate hypomagnesemia, such as more frequent detection, dietary recommendations, and timely replacement, should be considered in the overall cancer treatment plan for these patients.
背景。低镁血症是几种抗肿瘤药物已知所具有的一种副作用，但尚不清楚其对癌症患者预后的影响。我们对镁异常是否会影响接受卡铂化疗的卵巢癌患者的生存期进行了调查。
材料和方法。我们招募了 2004 年 1 月 1 日至 2014 年 12 月 31 日在我院进行手术和化疗的晚期卵巢癌患者。入选标准为年满 18 岁，病理表现为高级别浆液性癌，诊断后 60 天内首次接受治疗(手术或化疗)，并且化疗包含卡铂。最终队列由 229 名患者组成。我们在基线和治疗过程中记录了生命体征和实验室测试。并对镁异常(和其他临床特征)与生存期之间的关系进行了分析。
结果。患者中位年龄为 64 岁。较高的基线心率 [每分钟心跳次数；风险比 (HR)= 1.02，p = 0.002]和治疗过程中较高的低镁血症发生频率(HR = 1.05，p = 0.002)与生存期较短有显著关系，无论减瘤是否完全(HR = 1.60， p = 0.02)以及国际妇产科联盟分期(HR = 1.63，p = 0.01)如何。
结论。基线心率和治疗过程中的低镁血症发作频率会影响接受卡铂化疗和减瘤手术的晚期卵巢癌患者的生存预后。未来需要研究用于检测和预防该患者群体出现低镁血症的策略。
实践意义:尽管在每个化疗周期前都进行了标准实验室测试和静脉注射镁替代药物，低镁血症仍然是铂类化疗的常见副作用。本研究表明，在治疗过程中(包括卡铂化疗和减瘤手术)频繁出现低镁血症预计会缩短晚期卵巢癌患者的生存期。在这些患者的整体癌症治疗计划中，应考虑采取有效减轻低镁血症的策略，例如提高检测频率，提供饮食建议以及及时更换化疗药物。
Keywords: Carboplatin; Hypomagnesemia; Ovarian cancer; Survival.
© AlphaMed Press 2019.