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Naganuma A, Hoshino T, Ohno N, Ogawa Y, Murakami T, Horiguchi S, Uehara D, Suzuki Y, Hatanaka T, Kudo T, Ishihara H, Sato K, Kakizaki S, Takagi H. β-Hydroxy-β-methyl Butyrate/L-Arginine/L-Glutamine Supplementation for Preventing Hand-Foot Skin Reaction in Sorafenib for Advanced Hepatocellular Carcinoma. In Vivo 2019; 33:155-161. [PMID: 30587616 DOI: 10.21873/invivo.11452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/06/2018] [Accepted: 10/12/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND/AIM Sorafenib is standard treatment for advanced hepatocellular carcinoma (HCC). Hand-foot skin reaction (HFSR) is a notorious side-effect of this therapy. This study evaluated prophylactic benefits of an oral nutritional supplement (ONS) on sorafenib-associated HFSR in advanced HCC. PATIENTS AND METHODS This was a prospective, single-center, open-label trial arm using combined ONS and sorafenib in patients with unresectable HCC from August 2014 to February 2018. Control patients received sorafenib without ONS from 2011 to 2014. From September 2014, prophylactic ONS containing β-hydroxy-β-methylbutyrate (HMB), L-arginine, and L-glutamine was given. Sorafenib dosage was 400 mg/day for both groups. RESULTS Each group comprised 22 men and three women. Age, sex, Child-Pugh score, and clinical stage excluding IV-B did not significantly differ between the groups. HFSR occurred after 2 weeks: 15/25 patients in the control group (60%; HFSR grade 1: 6, grade 2: 7, grade 3: 2) vs. 8/25 in the ONS group (32%; HFSR grade 1: 4, grade 2: 4, grade 3: 0; p=0.047, Pearson's Chi-square test). CONCLUSION Prophylactic HMB, L-arginine and L-glutamine supplementation effectively prevented sorafenib-associated HFSR in patients with advanced HCC.
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Affiliation(s)
- Atsushi Naganuma
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan .,Nutrition Support Team, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan
| | - Takashi Hoshino
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan
| | - Nozomi Ohno
- Nursing Department, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan
| | - Yusuke Ogawa
- Nutrition Support Team, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan
| | - Tatsuma Murakami
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan
| | - Suguru Horiguchi
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan
| | - Daisuke Uehara
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan.,Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yuhei Suzuki
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan.,Department of Gastroenterology, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Takeshi Hatanaka
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan.,Department of Gastroenterology, Gunma ken Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Tomohiro Kudo
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan.,Nutrition Support Team, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan
| | - Hiroshi Ishihara
- Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan
| | - Ken Sato
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Satoru Kakizaki
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hitoshi Takagi
- Department of Gastroenterology, Kusunoki Hospital, Fujioka, Japan
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