Jiang HM, Sun R, Ning BJ, Yang XQ, Zhu XJ. Acute severe hypokalemia caused by treatment of tongue squamous cell carcinoma with docetaxel and cisplatin: A case report. World J Clin Oncol 2024; 15(10): 1309-1314 [DOI: 10.5306/wjco.v15.i10.1309]
Corresponding Author of This Article
Xiao-Ju Zhu, MSc, RN, Associate Chief Nurse, Teacher, Department of Cancer Center, Daping Hospital, Army Medical University, No. 10 Changjiang Zhilu, Yuzhong District, Chongqing 400042, China. 277264923@qq.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Oct 24, 2024; 15(10): 1309-1314 Published online Oct 24, 2024. doi: 10.5306/wjco.v15.i10.1309
Acute severe hypokalemia caused by treatment of tongue squamous cell carcinoma with docetaxel and cisplatin: A case report
Hong-Mei Jiang, Rong Sun, Bing-Jie Ning, Xue-Qin Yang, Xiao-Ju Zhu
Hong-Mei Jiang, Rong Sun, Bing-Jie Ning, Xue-Qin Yang, Xiao-Ju Zhu, Department of Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
Co-first authors: Hong-Mei Jiang and Rong Sun.
Author contributions: Jiang HM was the patients’ supervisor nurse, who carried out the study, reviewed the literature, contributed to manuscript drafting, and was responsible for revising the manuscript for important intellectual content; Sun R, Ning BJ, and Yang XQ reviewed the literature and contributed to manuscript drafting; Jiang HM, Sun R, Ning BJ, Yang XQ and Zhu XJ issued final approval for the version to be submitted.
Supported bythe Chongqing medical scientific research project (a joint project of the Chongqing Health Commission and Science and Technology), No. 2020ZY023716.
Informed consent statement: Written informed consent was obtained for the chemotherapy.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Ju Zhu, MSc, RN, Associate Chief Nurse, Teacher, Department of Cancer Center, Daping Hospital, Army Medical University, No. 10 Changjiang Zhilu, Yuzhong District, Chongqing 400042, China. 277264923@qq.com
Received: March 4, 2024 Revised: August 23, 2024 Accepted: September 6, 2024 Published online: October 24, 2024 Processing time: 208 Days and 17.6 Hours
Abstract
BACKGROUND
The tongue squamous cell carcinoma (TSCC) is an oral malignant tumor arising from the squamous epithelium of the tongue mucosa, characterized by a high malignant degree, invasive growth, early lymph node metastasis, and poor prognosis. Paclitaxel, represented by docetaxel, is now the standard first-line treatment for head and neck squamous cell carcinoma. Docetaxel, which belongs to the class of drugs known as paclitaxel, is an antitumor drug that inhibits cell mitosis and proliferation. Its adverse effects include myelosuppression, hair loss, gastrointestinal reactions, fluid retention, and allergic reactions. However, hypokalemia is rare, most cases are mild or moderate, and severe hypokalemia is seldom reported.
CASE SUMMARY
During chemotherapy with docetaxel and cisplatin, a patient with TSCC developed severe hypokalemia. His potassium level was found to have been reduced to 1.85 mmol/L at the most critical situation. The patient had grade 1 muscle strength in all four limbs and could not perform any action, which was considered to be a sign of severe hypokalemia. Measures taken included intravenous infusion via micro-pump, intravenous injection, and oral potassium supplement, which gradually improved muscle strength and serum potassium levels. The patient survived the critical period of severe hypokalemia after chemotherapy. He was generally in good condition following treatment and discharged in stable condition.
CONCLUSION
Docetaxel may cause severe hypokalemia with hypomagnesemia and the mechanism for this is not yet known to researchers yet. This means that nurses specializing in chemotherapy must exercise a high degree of responsibility, closely observe the patient’s reaction to the anticancer medication, notice any symptoms of adverse effects early. It is necessary to be considerate regarding individual differences between patients when selecting chemotherapy regimens and adhere to the principle of individualized treatment. Following multiple cycles of chemotherapy, patients should be aware of the accumulation of toxic side effects and receive blood tests reviewed within 24 hours of completion. It is essential to monitor electrolyte levels in patients suffering from severe gastrointestinal reactions to avoid complications that may result in death.
Core Tip: The patient with tongue squamous cell carcinoma who had severe hypokalemia combined with hypomagnesaemia on the third cycle of docetaxel combined with cisplatin chemotherapy, and recovered to normal after active potassium supplementation and other measures. After analysis, it was considered that the occurrence of hypokalemia in this patient may be related to docetaxel therapy, and docetaxel may cause increased potassium ion (K+) transfer into the cell, but the mechanism is still unclear. We hope to get the attention of peers through this case: For example, mechanistic studies of whether docetaxel might increase K+ to intracellular transfer, and healthy care should pay attention to any complaints and discomfort symptoms during the process of chemotherapy from cancer patients.
