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document
The effect of prophylactic calcium and magnesium infusions on the incidence of neurotoxicity and clinical outcome of oxaliplatin-based systemic treatment in advanced colorectal cancer patients . BACKGROUND Peripheral sensory neurotoxicity is a frequent and potentially debilitating side effect of oxaliplatin treatment . Calcium and magnesium ( Ca/Mg ) infusions are frequently used to prevent this toxicity . However , concerns about a negative impact of Ca/Mg infusions on outcome have been raised . We retrospectively assessed the effect of Ca/Mg infusions on the incidence of neurotoxicity and on clinical outcome in advanced colorectal cancer ( ACC ) patients treated in the phase III CAIRO2 study . MATERIALS AND METHODS Seven hundred and fifty five previously untreated ACC patients were randomised between treatment with capecitabine , oxaliplatin and bevacizumab or the same combination with the addition of cetuximab . Patients were retrospectively divided into two groups : patients in the Ca/Mg ( + ) group received Ca/Mg at least during their first treatment cycle , and patients in the Ca/Mg ( - ) group did not . RESULTS Seven hundred and thirty two patients were evaluable for this analysis . The Ca/Mg ( + ) group consisted of 551 patients , the Ca/Mg ( - ) group consisted of 181 patients . The incidence of all grade neurotoxicity in the Ca/Mg ( + ) group and the Ca/Mg ( - ) group was 85 % and 92 % , respectively ( p = 0.02 ) , and the incidence of grade ≥ 2 neurotoxicity was 40 % and 45 % , respectively ( p = 0.22 ) . The median PFS in the Ca/Mg ( + ) versus Ca/Mg ( - ) group was 10.1 versus 10.7 months ( p = 0.92 ) , the median OS was 19.8 versus 20.7 months ( p = 0.10 ) , and the response rate was 43.1 % versus 50 % ( p = 0.11 ) , respectively . CONCLUSIONS In this largest retrospective analysis to date we observed that Ca/Mg infusions significantly reduced all grade oxaliplatin-related neurotoxicity . Ca/Mg infusions did not affect the clinical efficacy of treatment .
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Intervention_Pharmacological
prophylactic calcium and magnesium infusions
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Intervention_Physical
treatment with
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Intervention_Pharmacological
capecitabine
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Intervention_Physical
,
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Intervention_Pharmacological
oxaliplatin
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Intervention_Physical
and
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Intervention_Pharmacological
bevacizumab
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Intervention_Physical
same combination with the addition of cetuximab
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Intervention_Physical
Ca/Mg ( + ) group
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Intervention_Physical
Ca/Mg
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Outcome_Physical
incidence of neurotoxicity
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Outcome_Physical
clinical outcome
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Outcome_Physical
all grade neurotoxicity
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Participant_Condition
advanced colorectal cancer patients
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Participant_Condition
advanced colorectal cancer ( ACC ) patients treated in the phase III CAIRO2 study
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Participant_Sample-size
Seven hundred and fifty five
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Participant_Sample-size
Seven hundred and thirty two patients were evaluable