Low serum magnesium implicated in the acute oxaliplatin-induced peripheral neuropathy

Acute peripheral neuropathy is dose limiting toxicity of oxaliplatin, a wildly used chemotherapeutic drug in colorectal cancer. The present study aimed to identify the relationship between pretreatment serum magnesium concentration and the acute oxaliplatin-induced peripheral neuropathy. We enlisted 318 colorectal cancer patients who received adjuvant or first-line oxaliplatin-based chemotherapy (either FOLFOX6 or XELOX) in this study. Before treatment, serum magnesium concentration was measured. The oxaliplatin-induced peripheral neuropathy was graded by using version 3 of the National Cancer Institute’s Common Toxicity Criteria (NCI-CTC v3). The association between serum magnesium concentration and peripheral neuropathy was evaluated. The acute oxaliplatin-induced peripheral neuropathy was diagnosed in 151 of 318 patients (47.5%). Patients with lower serum magnesium concentration (<0.76 mmol/L) had an elevated risk of severe peripheral neuropathy compared to those patients with higher serum magnesium concentration (≥0.76 mmol/L). The hazard ratio was 1.867 (95% confidence interval [CI] 1.151-3.030). This study provides independent support of pretreatment serum magnesium concentration as a novel marker of risk of the acute oxaliplatin-induced peripheral neuropathy.