Comparison of pre and post treatment serum magnesium levels in patients of head neck sqaumous cell carcinoma

Head & Neck squamous cell carcinoma (HNSCC) are the sixth most common cancer affecting adult males. Mg is required by more than 300 enzymes, nucleic acid, cation with ATP, modulating cell proliferation, cell cycle progression and differentiation. Recent studies have shown altered levels in serum of HNSCC patients. Carcinogenesis modifies the Mg status inducing distribution disturbances which may frequently associate a tumor Mg load with its depletion in nonneoplastic tissues. So this study aimed at studying alteration in serum Mg before and after therapy in HNSCC. 30 newly diagnosed patients with HNSCC and 30 age and sex matched healthy controls. Staging:-AJCC 2010 criteria. Treatment:- standard dose of radical external radiations (64 Gy/32 fractions for 6.2 weeks) and concomitant Carboplatin for stage III & IV with follow up after 6wks of treatment completion. Serum Mg was measured using Xylidyl Blue commercial kit form Randox[TM] on autoanalyzer. Average age was 53.37 [+ or -] 9.12 years for the 29 males & 1 female patient. Cancer location was laryngeal 11(36.7%), oropharynx 10(33%), base of tongue 6(20%) and tonsil 3(10%). 11 patients were in stage IV and 19 in stage III at diagnosis. Hypomagnesemia (< 1.46 mg/dL) was seen in 8(26.6%) before therapy and only 2(6.6%) patients after therapy. No significant difference was seen in pre-treatment (1.6 [+ or -] 0.44 mg/ dL) and post-treatment values (1.68 [+ or -] 0.19 mg/dL) (p = 0.641). Pretreatment Mg levels correlated only with total protein levels (r = 0.475, p = 0.008), while post-treatment levels correlated with uric acid (r = 0.412, p = 0.024), calcium (r = 0.514, p = 0.004), total protein (r = 0.421, p = 0.020) and albumin (r = 0.660, p = 0.000). Hypomagnesemia was seen in 26.6% patients before therapy. This needs to be studied further and incorporated in clinical management of HNSCC patients. After therapy hypomagnesemia was seen only in 6.6% patients and better correlated with uric acid, calcium suggesting relation with increased cell death post therapy.