Effects of magnesium supplementation in testicular cancer patients receiving cis-platin: A randomised trial

Abstract

Summary The concentration of magnesium in serum has been shown to fall to potentially dangerously low levels after several courses of treatment with cis-diamminedichloroplatinum II (cis-platin). The aims of this study were to examine the effects of magnesium supplementation on predicted outcome of treatment, rate of response to treatment and toxicity of treatment. Sixteen patients with testicular cancer were studied in detail over a 14 month period. One patient with an ovarian dysgerminoma was also included in the study. Eight patients were randomised to receive magnesium supplements both intravenous and oral; nine did not.The non-supplemented group showed significantly greater renal tubular damage as assessed by urine Nacetyl-B-D-glucosaminidase (NAG). There was a trend towards a reduction in treatment delays due to neutropenic episodes in the supplemented group, and serum magnesium concentrations remained significantly higher. Neither group showed differences in tumour growth rates or outcome. These results show that magnesium supplements are of considerable benefit and show no harmful effects in patients receiving cisplatin treatment. It is is suggested that magnesium supplements should be a routine part of the treatment regime, and that these should comprise both i.v. supplements during treatment and oral supplements between courses.

Influence of magnesium and parathyroid hormone on cisplatin-induced nephrotoxicity in esophageal squamous cell carcinoma

“…Although detailed tissue types were not considered in the present study, the results regarding increases in PTH or PTH-rP levels in patients with ESCC may be associated with this specificity. However, previous studies reported that Mg supplementation did not affect the tumor response to cisplatin-based chemotherapy (9,11,25). It was also concluded in the present study that Mg supplementation did not affect the efficacy of cisplatin-containing chemotherapy, as the overall survival time was similar between the patients with or without Mg supplementation (Fig.…”

“…1 and Table II). The protective effects of oral or intravenous Mg supplementation against cisplatin-induced nephrotoxicity have been reported in various types of malignancy, including in lung (10-12), head and neck (10,23,24), digestive (8,10), testicular (25), ovarian (9,24) and bladder (24) cancer. However, just a limited number of clinical reports have demonstrated the protective effects of intravenous Mg supplementation against cisplatin-induced nephrotoxicity in ESCC (10).…”

Changes in the serum, liver, and renal cortical lipids and electrolytesin rabbits with cisplatin-induced nephrotoxicity

“…Several studies have indicated the association of cisplatin toxicity with the depletion of serum magnesium, and magnesium supplementation was adopted to prevent hypomagnesemia during drug treatment (27). Hypomagnesemia was observed in humans (28) and in experimental animals (29). It was reported that in cisplatin-treated mice the urinary magnesium waste almost doubled (30), and the magnesium depletion was shown to enhance cisplatin nephrotoxicity (31).…”

Risk Factors Associated with Cisplatin-Induced Nephrotoxicity in Patients with Advanced Lung Cancer

“…Second, several previous studies reported that intravenous supplementation with Mg (magnesium) can prevent CIN. 26,38,39) Because our treatment protocol did not include Mg administration, we cannot state its efficacy in patients with these risk factors. Third, we defined the patients with a history of the cardiac disease such as angina and myocardial infarction as patients with cardiac disease in this study.…”