Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan.
Hepatol Res. 2016 Sep;46(10):1002-10. doi: 10.1111/hepr.12640. Epub 2016 Jan 26.
The therapeutic efficacy of branched-chain amino acid (BCAA) when added to sorafenib has not been fully assessed in patients with advanced hepatocellular carcinoma (HCC). This multicenter study investigated whether BCAA supplementation improves prognosis in patients with advanced HCC who underwent sorafenib treatment.
This retrospective analysis included 256 patients with advanced HCC treated with sorafenib, including 55 who did and 201 who did not receive BCAA supplementation. Clinical characteristics and outcomes in relation to Child-Pugh classification were compared in the two groups. Statistical analyses of univariate, multivariate and propensity score-based procedures were used for this study.
Assessment of 216 Child-Pugh A patients showed that median overall survival was significantly longer in patients with BCAA supplementation than in those without it (440 vs 299 days, P = 0.023). Multivariate analysis showed that BCAA supplementation (P = 0.023), low α-fetoprotein (<100 ng/mL) (P < 0.001), less progressive Barcelona Clinic Liver Cancer stage (A and B) (P = 0.007) and male sex (P = 0.018) were significant independent contributors to better overall survival. The significantly longer overall survival by BCAA supplementation was verified in the analysis using the propensity score in combination with the inverse probability of treatment weighted adjustment (P = 0.026). Assessment of the 40 Child-Pugh B patients showed no significant differences in overall survival between patients with and without BCAA supplementation.
BCAA supplementation may be a valuable adjunctive therapy for improving prognosis in sorafenib-treated Child-Pugh A patients with advanced HCC.
在晚期肝细胞癌（HCC）患者中，添加支链氨基酸（BCAA）的治疗效果尚未在索拉非尼治疗中得到充分评估。本多中心研究旨在探讨 BCAA 补充是否能改善接受索拉非尼治疗的晚期 HCC 患者的预后。
本回顾性分析纳入了 256 例接受索拉非尼治疗的晚期 HCC 患者，其中 55 例接受了 BCAA 补充，201 例未接受 BCAA 补充。比较了两组患者的临床特征和与 Child-Pugh 分级相关的结局。本研究采用单因素、多因素和倾向评分匹配分析。
对 216 例 Child-Pugh A 患者的评估显示，BCAA 补充组的中位总生存期明显长于未补充组（440 天 vs 299 天，P=0.023）。多因素分析显示，BCAA 补充（P=0.023）、低甲胎蛋白（<100ng/mL）（P<0.001）、较少进展的巴塞罗那临床肝癌分期（A 和 B）（P=0.007）和男性（P=0.018）是总生存期更好的独立影响因素。使用倾向评分和逆概率处理加权调整后，BCAA 补充的总生存期延长更为显著（P=0.026）。对 40 例 Child-Pugh B 患者的评估显示，BCAA 补充组和未补充组的总生存期无显著差异。
BCAA 补充可能是索拉非尼治疗晚期 Child-Pugh A 型 HCC 患者的一种有价值的辅助治疗方法，可改善预后。
Zotero 插件