This article evaluates the use of Calcium and magnesium (Ca/Mg) infusions for the prevention of Oxaliplatin-related neurological side effects in patients with colorectal cancer (CRC). The main findings were that Ca/Mg helps preventing neuro-toxic side effects of Oxaliplatin-based chemotherapy regimens.

Patients with advanced CRC (cancer of the large intestine that has spread to the lymph nodes or blood system) is chemotherapy. Oxaliplatin is a chemotherapeutic drug that kills cancer cells. Oxaliplatin is usually combined with other anti-cancer drugs called Fluorouracil (5-FU) and Folinic acid (Leucovorin) in a regimen known as FOLFOX. In 81.5% to 98% of patients, Oxaliplatin causes a side effect known as neuropathy or neurotoxicity. Neuropathy is often reversible, and involves numbness in the hands and feet, increased sensitivity to cold, tingling, itching, sense of pins and needles, and even intense pain. 15% of patients however suffer chronic symptoms (mostly numbness) following cumulative doses of Oxaliplatin. In approximately 10% of patients these symptoms are permanent. Ca/Mg infusions are commonly used clinically to prevent Oxaliplatin-related neurotoxicity, but their usefulness is unclear. 

This study looks at assembled results from seven clinical trials including altogether 1170 patients with advanced CRC. 802 patients received Ca/Mg along with standard chemotherapy (FOLFOX) and 368 patients received chemotherapy only. Two of the clinical trials showed that significantly less patients who received Ca/Mg infusion suffered acute symptoms following chemotherapy. Six of the trials showed that the number of patients who suffered from cumulative neurotoxic side effects (chronic symptoms after prolonged exposure to Oxaliplatin) was smaller in the Ca/Mg treatment group.

In summary, this paper indicates that Ca/Mg tends to decrease neurotoxic side effects when given alongside a chemotherapy regimen which includes Oxaliplatin. As a result this lengthens the period patients can tolerate this type of chemotherapy treatment, and improves patients' quality of life.

This paper has some limitations. The number of patients included is small, considering the 7 trials that were included. Moreover, four of the studies were terminated early. As a result these studies did not enroll the number of patients they initially planned to.

Another drawback is in the fact that it used retrospective studies. These are studies where patient records have been analyzed to find the data rather than following a patient from the start of treatment. Retrospective studies may be biased.