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

In 30 seconds

This randomized controlled trial evaluated intravenous magnesium sulfate for prevention of cisplatin-induced nephrotoxicity in 100 newly diagnosed patients with head and neck squamous cell carcinoma receiving concurrent radiotherapy. Participants were assigned to cisplatin alone or cisplatin with 1, 2, or 3 g of magnesium sulfate over seven weekly cycles. All magnesium groups had significantly lower urinary KIM-1 and NGAL than the control group (P < 0.05). At cycle 7, serum sFasL and MDA were significantly lower with 3 g than with cisplatin alone (P < 0.05); the 3-g dose also reduced these measures versus the 1- and 2-g doses.

Key findings

• Urinary KIM-1 and NGAL were significantly lower in each magnesium group than in the cisplatin-only control group (P < 0.05).
• After cycle 7, serum sFasL and MDA were significantly lower with 3 g magnesium sulfate than with cisplatin alone (P < 0.05).
• The 3-g dose reduced serum sFasL and MDA significantly compared with both the 1-g and 2-g doses (P < 0.001 for the reported comparison).

Why it matters

Cisplatin-associated renal injury can complicate cancer treatment. This trial suggests that magnesium supplementation may lessen changes in several renal injury and oxidative-stress biomarkers during cisplatin-based chemoradiotherapy. The findings provide a rationale for further evaluation of magnesium as a nephroprotective adjunct, while biomarker improvements alone do not establish the extent of clinical kidney protection.

What to keep in mind

The reported results emphasize biomarkers; the abstract does not provide quantitative clinical kidney outcomes or details of follow-up beyond the seven treatment cycles.