DOI: 10.4103/ijp.ijp_224_26 ISSN: 0253-7613

Role of magnesium as a protective agent in cisplatin-induced nephrotoxicity in head and neck cancer

Mohamed Saad Saad Younis, Mohamed Abdo El-Shebiny, Sahar Mohamed El-Haggar

Abstract:

PURPOSE:

This study seeks to evaluate the safety and efficacy of magnesium (MgSO 4 ) as a protective agent against cisplatin-induced nephrotoxicity (CIN) in cases with head and neck cancers (HNC).

METHODS:

One-hundred newly diagnosed squamous cell carcinoma HNC were randomly allocated into 4 groups: 25 cases in each. Group 1 (control group) received cisplatin 40 mg/m 2 for 7 cycles (each cycle is 1 week). Group 2 received cisplatin 40 mg/m 2 and 1 g of parenteral MgSO 4 intravenous infusion (IVI) for 7 cycles. Group 3 received cisplatin 40 mg/m 2 and 2 g of parenteral MgSO 4 IVI for 7 cycles. Group 4 received cisplatin 40 mg/m 2 and 3 g of parenteral MgSO 4 for 7 cycles. All four groups received radiotherapy concurrent with cisplatin for 7 cycles.

RESULTS:

The groups containing Mg IVI as (MgSO 4 ) had a significant improvement (lower level) in Urine kidney injury molecule-1 (KIM-1) and Urine Neutrophil gelatinase associated lipocalin (NGAL) than Group I (control group) ( P < 0.05). Serum soluble Fas ligand (sFasL) and Malondialdehyde (MDA) after the end cycle (7 cycle) was significantly decreased in Group IV than group I (control group) ( P < 0.05), MgSo 4 was significantly decreased in Group IV (3 g Mg) than Group III (2 g Mg) ( P < 0.001) and Group II (1 g Mg).

CONCLUSIONS:

Mg can serve as a protective agent against CIN, as it reduces renal injury biomarkers, including urinary KIM-1, urinary NGAL, serum sFasL, and serum MDA when incorporated into treatment regimens at different doses, compared to cisplatin alone. Moreover, Mg had a promising role in the improvement of quality of life in cases with HNC receiving cisplatin.

More from our Archive