Hypomagnesemia and incidence of osteoradionecrosis in patients with head and neck cancers

Background: We aimed to determine whether hypomagnesemia predicts osteoradionecrosis development in patients with squamous cell carcinoma of the oropharynx and oral cavity who received platinum-based concurrent chemoradiation with or without induction therapy. Methods: We reviewed data from patients with head and neck cancers who had undergone chemoradiation with weekly cisplatin/carboplatin between January 1, 2010 and December 31, 2014 at our institution. Pathologic features, laboratory test results, disease stage, and social histories were recorded. The association between hypomagnesemia and osteoradionecrosis was analyzed controlling for known confounding factors. Results: Hypomagnesemia during cancer treatment was associated with osteoradionecrosis development (HR = 2.72, P =.037) independent of total radiation dose (HR = 1.07, P =.260) and smoking history (HR = 2.05, P =.056) among the patients who received platinum-based induction chemotherapy followed by concurrent chemoradiation. Conclusions: Hypomagnesemia was predictive of the development of osteoradionecrosis in patients with cancers of the oropharynx and oral cavity receiving platinum-based induction followed by concurrent chemoradiation.