title: Pilot clinical trial of the use of alpha-tocopherol for the prevention of hepatocellular carcinoma in patients with liver cirrhosis.
abstract: Patients with chronic hepatitis C virus (HCV) infection often develop liver cirrhosis and hepatocellular carcinoma (HCC). The purpose of this study was to test the chemopreventive effect of alpha-tocopherol on hepatocarcinogenesis in patients with liver cirrhosis and a history of HCV infection. Eighty-three patients with liver cirrhosis and with positive history of HCV infection were divided at random into two groups. Forty-four patients were treated with alpha-tocopherol (Vit E group) while the other 39 were followed as controls. The clinical background (gender, age, and laboratory data) was similar in the two groups. Serum levels of alpha-tocopherol, albumin, alanine aminotransferase (ALT), and total cholesterol and platelet count were measured serially over a period of five years. The mean serum concentration of alpha-tocopherol was low in both groups at entry and was significantly higher in the Vit E group than in the control group one month after treatment. Platelet count, serum albumin, ALT, and total cholesterol were not different between the two groups during the five-year period. Cumulative tumor-free survival and cumulative survival rate tended to be higher in the Vit E group than in controls, albeit statistically insignificant. The serum level of alpha-tocopherol was low in patients with liver cirrhosis and positive for HCV. Although the administration of alpha-tocopherol normalized the level one month later, it could neither improve liver function, suppress hepatocarcinogenesis, nor improve cumulative survival. Patients treated with alpha-tocopherol tended to live longer without development of HCC but the difference was not statistically significant.
authors.affiliation: First Department of Internal Medicine, Gunma University Faculty of Medicine, 3-39-15, Showa Machi Maebashi, 371-8511, Japan. htakagi@med.gunma-u.ac.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takagi
authors.forename: Satoru
authors.initials: S
authors.lastname: Kakizaki
authors.forename: Naondo
authors.initials: N
authors.lastname: Sohara
authors.forename: Ken
authors.initials: K
authors.lastname: Sato
authors.forename: Gengo
authors.initials: G
authors.lastname: Tsukioka
authors.forename: Youko
authors.initials: Y
authors.lastname: Tago
authors.forename: Kazuko
authors.initials: K
authors.lastname: Konaka
authors.forename: Kenshi
authors.initials: K
authors.lastname: Kabeya
authors.forename: Mieko
authors.initials: M
authors.lastname: Kaneko
authors.forename: Hisashi
authors.initials: H
authors.lastname: Takayama
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamada
authors.forename: Hitomi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimojo
authors.forename: Takeaki
authors.initials: T
authors.lastname: Nagamine
authors.forename: Masatomo
authors.initials: M
authors.lastname: Mori
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000975:Antioxidants / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000821:virology; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010976:Platelet Count; D012709:Serum Albumin / Q000032:analysis; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis; D024502:alpha-Tocopherol / Q000097:blood / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D012709:Serum Albumin; D000509:alpha-Fetoproteins; D002784:Cholesterol; D000410:Alanine Transaminase; D024502:alpha-Tocopherol