Effect of Oral Supplementation with Branched-chain Amino Acid (BCAA) during Radiotherapy in Patients with Hepatocellular Carcinoma: A Double-Blind Randomized Study

Abstract

Purpose: The present study evaluated whether oral supplementation with a branched-chain amino acid (BCAA) improves the biochemical and amino acid profiles of liver tumor patients undergoing radiotherapy.

Materials and methods: Patients were randomly assigned to one of 2 groups: a group given oral supplementation with BCAA granules (LIVACT granules; Samil Pharm Co., Korea, each granule containing L-isoleucine 952 mg, L-leucine 1,904 mg, and L-valine 1,144 mg) during radiotherapy, or a placebo group. Physical and biochemical examinations and measurements, including subjective symptoms, Child-Pugh class, body mass index, plasma albumin concentration, and plasma amino acid profiles were monitored.

Results: Fifty were enrolled between November 2005 and November 2006. We also analyzed data from 37 hepatocellular carcinoma (HCC) patients in order to evaluate a more homogenous group. The two groups of patients were comparable in terms of age, gender, Child-Pugh score, and underlying hepatitis virus type. Serum albumin, total protein, liver enzymes, and cholesterol showed a tendency to increase in the BCAA group. In this group, the percentage of cases that reverted to normal serum albumin levels between 3 and 10 weeks after administration of BCAA was significantly higher (41.18%) than in the placebo group (p=0.043).

Conclusion: Oral supplementation with a BCAA preparation seems to help HCC patients undergoing radiotherapy by increasing the BCAA concentration.

Keywords: Branched-chain amino acids; Hepatocellular carcinoma; Radiotherapy.

Fig. 1

Trial design. Subjects were randomized into branched-chain amino acid (BCAA) and placebo groups. Subjective symptoms, Child-Pugh score, biochemical profiles, and nutritional states were evaluated. CBC, complete blood count.

Fig. 2

Changes in biochemical profiles showing no significant differences between patients treated with branched-chain amino acid (BCAA) and placebo. (A) Total cholesterol. (B) Serum triglyceride. (C) Serum total protein. (D) Serum albumin. (E) Serum aspartate aminotransferase (AST). (F) Serum alanine aminotransferase (ALT). (G) Serum bilirubin.

Fig. 3

Percentage of patients whose serum albumin returned to a normal level. Serum albumin levels recovered from 3 to 10 wk in the branched-chain amino acid (BCAA) treatment group (p= 0.043).