447P - Hypomagnesaemia: An unnoticed problem in lung cancer patients treated with concurrent chemoradiation

Background

Hypomagnesaemia is a well-known side-effect in patients receiving cisplatin-containing chemotherapy. However, a small number of patients, who are receiving weekly cisplatin along with radiotherapy, will show symptoms. Till date in Bangladesh no study has been done to find out the incidence of hypomagnesaemia in concurrent chemo-radiotherapy patients.

Methods

This observational study was done between January, 2018 and February, 2019 at the Cancer Care Center of United Hospital Limited, Dhaka, Bangladesh. A total of 100 non-metastatic lung cancer patients were included in this study. Inclusion criteria were: patients treated with concurrent chemo-radiotherapy and weekly cisplatin; no prior chemotherapy; no prior kidney diseases; ECOG PS 1-2. All patients were treated with 40mg/m² cisplatin weekly with radiotherapy. Radiotherapy doses were range in 60Gy to 70Gy in 2Gy per fraction. During chemotherapy 1000cc 0.9%NaCl saline was used as pre-hydration and post-hydration. Magnesium level was checked at week 1, week 3 and week 6. Events were categorized according common terminology criteria for adverse events v.4.0. In very severe cases IV magnesium was used, and in mild to moderate cases oral supplement has been used.

Results

Among 100 patients, 63 patients suffered various degrees of hypomagnesaemia. 23 patients were symptomatic for hypomagnesaemia and needed IV correction. And 27 patients were suffering from mild hypomagnesaemia. It has been observed that elderly patients suffer more; 41 patients were above the age of 60 years.

Conclusions

Although hypomagnesaemia is rarely symptomatic, it should be kept in mind that severe grade of hypomagnesaemia can cause fatal damage especially in elderly patients. As, Bangladesh is a developing country and accordingly to their food habits, people have low amounts of dietary magnesium as usual. This finding drives us, to change our daily practice to add IV magnesium (2.5mg/5ml) during post-hydration along with 20mmol potassium n weekly cisplatin chemotherapy to prevent hypomagnesaemia. This was a practice changing finding in our canter. To validate this observational finding we need large prospective multicenter data.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.