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Hypomagnesemia and survival in patients with head and neck cancers who received primary concurrent chemoradiation
Author(s) -
Liu Wenli,
Qdaisat Aiham,
Ferrarotto Renata,
Fuller Clifton D.,
Guo Ming,
Meyer Larissa A.,
Narayanan Santhosshi,
Lopez Gabriel,
Cohen Lorenzo,
Bruera Eduardo,
Hanna Ehab Y.,
Yeung SaiChing J.
Publication year - 2021
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.33283
Subject(s) - medicine , hypomagnesemia , carboplatin , head and neck cancer , cancer , oncology , retrospective cohort study , radiation therapy , hazard ratio , chemotherapy , surgery , cisplatin , confidence interval , materials science , magnesium , metallurgy
Background Prior research has confirmed that persistent hypomagnesemia was predictive of shorter survival among patients with ovarian cancer who received carboplatin‐based chemotherapy. In the current retrospective study, the authors examined the association between hypomagnesemia and survival in patients with head and neck cancer who received concurrent chemoradiation with weekly infusions of cisplatin and/or carboplatin. Methods Patients with head and neck cancers who had undergone chemoradiation with cisplatin and/or carboplatin between January 1, 2010, and December 31, 2014, were included. Patients were aged ≥18 years with pathology of squamous cell carcinoma of the larynx, oral cavity, or oropharynx who had received at least 30 fractions of radiotherapy with concurrent weekly cisplatin and/or carboplatin. Pathology features, laboratory results, Eastern Cooperative Oncology Group performance status, social histories, and survival were recorded. The association between hypomagnesemia and survival was analyzed controlling for known prognostic factors. Results The final cohort consisted of 439 patients with a median age of 59 years. A greater frequency of hypomagnesemia during the treatment course was found to be significantly associated with shorter survival (hazard ratio [HR], 1.13; P = .033) independent of age (HR, 1.65; P = .042), cancer site (nonoropharynx vs oropharynx: HR, 2.15 [ P = .003]), Eastern Cooperative Oncology Group performance status (>1 vs ≤1: HR, 2.64 [ P < .001]), and smoking history (smoker vs nonsmoker: HR, 1.88 [ P = .012]). In addition, more severe hypomagnesemia was associated with shorter survival compared with the milder form. Conclusions The frequency and severity of hypomagnesemia during treatment are prognostic of survival for patients with head and neck cancers who are receiving concurrent chemoradiation with cisplatin and/or carboplatin. A prospective study is needed to investigate the impact of the prevention of hypomagnesemia on survival in this patient population.