Local and systemic toxicity of intra-hepatic-arterial 5-FU and high-dose or low-dose leucovorin for liver metastases of colorectal cancer

Abstract

In an ongoing prospective study 11 patients with unresectable liver metastases from colorectal caracinoma have been treated with hepatic-arterial infusion of 5-FU (1 g m −2) for 24 h on days 1 to 5 combined with a rapid infusion of high-dose leucovorin (100 mg m −2) (HD-regimen) or low-dose leucovorin (20 mg m −2) (LD-regimen) on days 1, 3 and 5. There was only mild local toxicity grade 1 and grade 2 in both regimen. Twenty-four cycles with high-dose leucovorin and 42 cycles with low-dose leucovorin showed a mild to moderate systemic toxicity, including haematological changes, stomatitis and diarrhoea. We did not see any grade 4 toxicity and no treatment-related fatalities occurred in this series. Eighty per cent reduction of leucovorin dosage leads to a significant decrease in grade 2 and grade 3 haematological and gastrointestinal toxicity.