Abstract
BackgroundHyponatremia is a common electrolyte abnormality in cancer patients who receive chemotherapy. Among anticancer agents, platinum-based agents are reported to cause chemotherapy-induced hyponatremia. However, the actual incidence and risk factors remain unknown.ResultsThe reports of 29 trials were analyzed. The incidence of grade 3/4 hyponatremia was 11.9% in patients treated with platinum-based chemotherapy and 3.8% in those treated with nonplatinum-based regimens (P < 0.01). Univariable analysis revealed a high incidence of hyponatremia in patients receiving cisplatin, three-drug combination regimen, two-drug combination regimen with amrubicin or irinotecan, or high-dose cisplatin (weekly equivalent cisplatin dose ≥20 mg/m2), and in patients with small-cell lung cancer.ConclusionThis is the first report of the actual incidence and the potential risk factors of chemotherapy-induced hyponatremia. Careful monitoring of serum sodium level is needed when platinum-based chemotherapy is administered.MethodsThis study included all clinical trials of systemic chemotherapies for solid cancers that were conducted by the Japan Clinical Oncology Group (JCOG) after January 2000 and of which the patient enrolment was completed by January 2014. The latest reports of each trial were used for analysis. The incidence of chemotherapy-induced grade 3/4 hyponatremia and the potential risk factors were investigated with univariable analysis.
Highlights
Hyponatremia is a common electrolyte disorder in cancer patients
The incidence of grade 3/4 hyponatremia was 11.9% in patients treated with platinum-based chemotherapy and 3.8% in those treated with nonplatinum-based regimens (P < 0.01)
Univariable analysis revealed a high incidence of hyponatremia in patients receiving cisplatin, three-drug combination regimen, two-drug combination regimen with amrubicin or irinotecan, or high-dose cisplatin, and in patients with small-cell lung cancer
Summary
Hyponatremia is a common electrolyte disorder in cancer patients. Recent studies suggest that hyponatremia might be a negative prognostic factor for cancer patients its early detection and appropriate management might improve patient outcome [1–3]. The reported incidence of hyponatremia in cancer patients varies greatly according to the cancer type, clinical setting, and the serum sodium cutoff point, from 4% to 44% [4–7]. Chemotherapy-induced hyponatremia is an important adverse event because a rapid decrease in serum sodium level leads to disturbance of consciousness, convulsions, respiratory arrest, and treatment-related death in the worst-case scenario. Hyponatremia is a common electrolyte abnormality in cancer patients who receive chemotherapy.
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