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Role of calcium and magnesium infusion in prevention of oxaliplatin neurotoxicity. A phase III trial

The Chinese-German Journal of Clinical Oncology 2013年第5期12卷 232-236页

作者： nagy samy gobran Clinical Oncology Department Ain Shams University

Objective： This study is a prospective randomized, double-blind, placebo-controlled study to evaluate the effect of calcium and magnesium （Ca/Mg） infusion on amelioration of oxaliplatin neuropathy, the dose-limiting toxicity. Methods： Sixty patients with resected colorectal carcinoma （CRC） planned to receive adjuvant oxaliplatin-containing regimen were randomly assigned to two arms; Arm A： patients received Ca/Mg were given as 1 gm Ca gluconate and 1 gm MgSO4 in 250 mL of intravenous （IV） solution over 30 rain pre and post oxaliplatin infusion, and Arm B： patients received 250 mL of IV solution without Ca/Mg over 30 min pre and post oxaliplatin infusion. Primary outcome was to assess percentage of patients with oxaliplatin-induced neurotoxicity. Neurotoxicity was assessed according to the National Cancer Institute Common Terminology Criteria forAdverse Events （NCI-CTCAE） version 3.0. Results： Sixty patients in both arms were assessed, 30 with Ca/Mg infusion and 30 without. Patients developed neurotoxicity in arm A were significantly lower than that in arm B after the end of treatment; 7 （23.3%） and 14 （46.6%） respectively （P 〈 0.05）, and significantly lower duration of neuropathy in months （8 ± 2.5 vs 18 ±3） respectively （P 〈 0.001）. Conclusion： Use of IV Ca/Mg showed a statistically significant reduction of peripheral neuropathy （PN） in patients with CRC receiving oxaliplatin in the adjuvant settings.

关键词： colorectal carcinoma (CRC) oxaliplatin, neurotoxicity, calcium and magnesium (Ca/Mg)infusion

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Chemotherapy Toxicity Profile in Adjuvant Treated Colorectal Carcinoma Patients

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Journal of Cancer Therapy 2020年第2期11卷 74-87页

作者： nagy samy gobran Mohammed Reda Kelany Mohammed Abdallah Fathy Clinical Oncology & Nuclear Medicine Department Ain Shams University Cairo Egypt

Background:?Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer-related deaths in the world. The treatment of stage III CRC consists of surgery followed by adjuvant chemotherapy with either single agent capecitabine or combination therapy consisting of FOLFOX?or XELOX, all of which have been shown to be effective in improving disease-free survival (DFS) and overall survival (OS). However, toxicities acquired from chemotherapy can affect a cancer patient’s quality of life and result in early?treatment discontinuation. Common toxicities include hematological, gastrointestinal (GI), constitutional, dermatological, and neurological.?Aim of the Work: The present work was aimed to assess and evaluate chemotherapy toxicities in adjuvant treatment in CRC patients and analyze certain factors that might increase chemotherapy toxicity. Patients and Methods: This is retrospective study included a total of 72 patients of colorectal carcinoma received adjuvant chemotherapy at Clinical Oncology Department, Ain Shams University. The study was conducted between Jan. 2012 and Jan. 2017. Results: We found that?the most chemotherapy reported was neurological toxicity in (73.6%), gastrointestinal symptoms (diarrhea 52.7%, nausea 30.6%, vomiting 27.8% & oral mucositis 24%), hematological toxicity (neutropenia 40.3%, anemia 34.7%, thrombocytopenia 12.5%), fatigue 20.9%, hepatic toxicity 18.1%, dermatological toxicity 9.7% & renal toxicity 5.6%). older patients have significant incidence of neurological toxicity (p-value?= 0.023) and fatigue (p-value?= 0.038). females have significant incidence of anemia (p-value = 0.017). increase of oxaliplatin?cumulative dose increase incidence of neurological toxicity (p-value?= 0.024), thrombocytopenia (p-value?= 0.007) and renal toxicity (p-value?= 0.030). Oxaliplatin containing regimens have high significant correlation with neurological toxicity (p-value = 0.000) and capcitabine has high significant correl

关键词： Chemotherapy Toxicity Adjuvant Chemotherapy CRC

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Factors Predicting Transformation of Non-Severe Pre-Eclampsia into Pre-Eclampsia with Severe Features

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 153-165页

作者： Mohammed Mahmoud samy Ahmed nagy Abdul-Rahman Younis Karim Mohammed Labib Departmenrt of Obstetrics and Gynecology Faculty of Medicine Ain Shams University Cairo Egypt Ain Shams University Cairo Egypt

Background: Pre-eclampsia (PE), a complex, multisystem, pregnancy-associated hypertensive disorder, typically developing after the 20th week of gestation, that complicates 2% - 8% of pregnancies, is a leading cause of neonatal and maternal mortality and morbidity. Aim of the Work: To identify different factors predicting transformation of non-severe pre-eclampsia in to pre-eclampsia with severe features. Patients and Methods: This prospective cohort study was conducted at tertiary care hospital at Ain Shams University hospitals from June 2021 till January 2022 and performed on total of 100 patients who diagnosed as non-severe pre-eclampsia after exclusion of severity features. Results: The current study revealed that transformation to severe pre-eclampsia occurred in 33% of the studied cases. Body mass index (BMI), past and family histories of preeclampsia statistically were significantly higher in cases transformed into preeclampsia with severe features. Admission blood pressure, albumin dipstick, Oligohydramnios and IUGR statistically were significantly higher in cases with transformation from non-severe pre-eclampsia into pre-eclampsia with severe features. Platelet count statistically was significantly lower in cases with transformation from non-severe pre-eclampsia into pre-eclampsia with severe features Conclusion: Our study results identified the most important clinical risk factors for transformation to severe features of pre-eclampsia from non-severe features and provided new information on the level of risk associated with specific combinations of risk factors (BMI ≥ 35.4, admission systolic blood pressure, admission diastolic blood pressure, albumin dipstick 4+ and platelets count) with low significant diagnostic performance in predicting transformation from non-severe pre-eclampsia into pre-eclampsia with severe features.

关键词： Pre-Eclampsia Blood Pressure Body Mass Index Platelet Count

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