The Clinical Study Of Prevention Of Oxaliplatin-Related Neurotoxicity By Magnesium Sulfate And Calcium Gluconate Infusions

Oxaliplatin is the third-generation platinum. Several Studies show that Oxaliplatin has inhibitory effect on some tumour cell lines in vivo and vitro, including in which resistant to cisplatin or carboplatin. Oxaliplatin is active in colorectal cancer, gastric cancer, lung cancer et al. Neurotoxicity is its dose-limiting toxicity, which may comes from an effect on neuronal voltage-gated Na channels through the liberation its metabolite, oxalate. We decided to use Ca⁺⁺ and Mg⁺⁺ as oxalate chelators to prevent the neurotoxicity caused by Oxaliplatin.In this study, 47 patients treated with oxaliplatin-based regimen were randomized to two groups. 24 patients in A group (test group) received chemotherapy combination with magnesium sulfate and calcium gluconate. 23 patients in B group (control group) received chemotherapy alone. A group received infusions of Ca gluconate (10% Ca gluconate 10ml add in 10% dextrose 20ml, infusion for 15mins) and Mg sulfate (25 % Mg sulfate 4ml add in 5 % dextrose 250ml, infusion for 1hr) 8 hour before and after infusion of oxaliplatin . Oxaliplatin add in 5% dextrose were given within 2-3hr infusion. Nerve conduction velocity was performed at baseline and after four cycles of chemotherapy in all patients. Aspecific neurotoxicity scale was used for oxaliplatin-related neurotoxicity after four cycles of chemotherapy.Result: After four cycles, only 4 of 24 assessable patients in the group A suffered from Grade 1 neurotoxicity. 12 of 23 assessable patients in the group B suffered from neurotoxicity, including 9 cases for Grade 1,2 cases for Grade 2 ,1 case for Grade 3 neurotoxicity. The incidence rate of neurotoxicity in group A was 16.6% and that in group B was 52.1% , there were significant deviation between two groups(P<0.05) . The nerve conduction velocity showed abnormal change of neurophysiology in patients who suffered from neurotoxicity.Conclusions: Magnesium Sulfate and Calcium Gluconate infusion can reduce the incidence of Oxaliplatin-Related Neurotoxicity.