Yamamoto Yoshihiro, Watanabe Kazushi, Matsushita Hiroshi, Tsukiyama Ikuto, Matsuura Katsuhiko, Wakatsuki Akihiko
Departments of Pharmacy, Aichi Medical University Hospital.
Yakugaku Zasshi. 2017;137(1):79-82. doi: 10.1248/yakushi.16-00185.
Hypomagnesemia is one side effect in patients receiving cisplatin. However, there are few reports of cisplatin-induced hypomagnesemia in Japan. We retrospectively investigated the incidence of hypomagnesemia and nephrotoxicity in patients undergoing radiation therapy who were treated with cisplatin alone (dosage: 40 mg/m, administration interval: 1 week) for cervical cancer. Thirty-two patients undergoing radiation therapy who received cisplatin alone for cervical cancer between January 2012 and May 2016 at Aichi Medical University Hospital were included. We measured patients' serum magnesium and creatinine levels on the day before cisplatin was administered. We utilized the RIFLE criteria (categorized into "risk", "injury", "failure", "loss", and "end-stage kidney disease") to define levels of cisplatin-induced nephrotoxicity, and classified cisplatin-induced nephrotoxicity into "risk" or "injury". Eighteen patients (56.3%) had cisplatin-induced hypomagnesemia, the majority of which occurred after the 4th treatment cycle. The number of patients with moderate renal dysfunction classified as "risk" in the hypomagnesemia group was not significantly higher than in the non-hypomagnesemia group (hypomagnesemia group=27.8%, non-hypomagnesemia group=7.1%; p=0.20). This survey sheds light on the incidence rates of cisplatin-induced hypomagnesemia in patients receiving cisplatin alone. We recommend monitoring the serum magnesium levels during cisplatin administration to prevent hypomagnesemia.
低镁血症是接受顺铂治疗患者的一种副作用。然而,在日本,关于顺铂诱导的低镁血症的报道较少。我们回顾性调查了仅接受顺铂(剂量:40mg/m²,给药间隔:1周)治疗宫颈癌的放疗患者中低镁血症和肾毒性的发生率。纳入了2012年1月至2016年5月期间在爱知医科大学医院仅接受顺铂治疗宫颈癌的32例放疗患者。我们在给予顺铂前一天测量了患者的血清镁和肌酐水平。我们利用RIFLE标准(分为“风险”“损伤”“衰竭”“丧失”和“终末期肾病”)来定义顺铂诱导的肾毒性水平,并将顺铂诱导的肾毒性分为“风险”或“损伤”。18例患者(56.3%)发生了顺铂诱导的低镁血症,其中大多数发生在第4个治疗周期后。低镁血症组中被分类为“风险”的中度肾功能不全患者数量并不显著高于非低镁血症组(低镁血症组=27.8%,非低镁血症组=7.1%;p=0.20)。这项调查揭示了仅接受顺铂治疗的患者中顺铂诱导的低镁血症的发生率。我们建议在顺铂给药期间监测血清镁水平以预防低镁血症。