Key result
Frequent hypomagnesemia during head and neck chemoradiation is linked to ~13% higher mortality.
Why the study?
The prognostic significance of hypomagnesemia during concurrent chemoradiation in patients with head and neck cancer was unclear.
Cohort (n=439)
Hazard Ratio: 1.13
p-value: p=.033
Hypomagnesemia may be prognostic during head and neck chemoradiation; extends ovarian observations but remains hypothesis-generating.
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.
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Liu et al. (2020) conducted a cohort in Head and neck cancers (n=439). Hypomagnesemia vs. Lower frequency or milder hypomagnesemia was evaluated on Survival (HR 1.13, p=.033). A greater frequency of hypomagnesemia during concurrent chemoradiation for head and neck cancer was significantly associated with shorter survival (HR 1.13; P=0.033).
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