Safety and efficacy of calcium and magnesium infusions in the chemoprevention of oxaliplatin-induced sensory neuropathy in gastrointestinal cancers

Abstract

Objective: To derive a more precise estimation on the safety and efficacy of calcium and magnesium (Ca and Mg) infusions in the prevention of oxaliplatin-induced sensory neuropathy. Methods: A total of 16 studies including 1765 individuals were involved in this meta-analysis. Odds ratio (OR) and its 95% confidence interval (CI) were calculated. Results: The difference in the incidence of oxaliplatin-induced neuropathy grade ≥1 was statistically significant between the Ca and Mg infusions treatment group and the untreated group (National Cancer Institute common toxicity criteria [NCI CTC]: OR 0.44, 95% CI 0.31-0.62, P=0.000; oxaliplatin-specific scale [OSS]: OR 0.30, 95% CI 0.20-0.45, P=0.000). Similar results were found in the incidences of oxaliplatin-induced neuropathy grade ≥2 (NCI CTC: OR 0.60, 95% CI 0.46-0.77, P=0.000; OSS: OR 0.45, 95% CI 0.30-0.67, P=0.000). However, we did not detect a trend of fewer oxaliplatin-induced neuropathy grade ≥3 incidences in the Ca and Mg infusions treatment group than the untreated group (NCI CTC: OR 0.67, 95% CI 0.44-1.01, P=0.054; OSS: OR 0.66, 95% CI 0.34-1.29, P=0.224). There was no difference in the response rate between the Ca and Mg treated group and the untreated group (OR 0.89, 95% CI 0.67-1.17, P=0.391). Conclusion: Ca and Mg infusions do not alter the efficacy of oxaliplatin-based chemotherapy in gastrointestinal cancers, which may be reasonable to add them to lessen the incidence of neuropathy. © 2013 The Authors. Journal of Digestive Diseases © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.