Low-dose Leucovorin and 5-Fluorouracil for Unresectable Multiple Liver Metastasis from Colorectal Cancer

Abstract

In the present study, a retrospective investigation was conducted to determine whether or not it was possible to obtain a comparable survival time, response rate (RR) and modest toxicity combining low-dose leucovorin (LV) and 5-Fluorouracil (5-FU) (LV/5-FU) with hepatic arterial infusion (HAI) or systemic intravenous infusion (SI) for patients with unresectable liver metastasis from colorectal cancer (CRC). Patients and Methods: Patients were given LV at 20 mg/m² immediately followed by 5-FU at 370 mg/m² with a 2-hour SI or HAI daily for 5 consecutive days with courses repeated every 5 weeks. Twenty patients received HAI and 16 patients received SI. Survival, response and toxicity were assessed. Results: The median survival time (MST) of all patients was 20.0 months. The MST of the HAI and SI patients was 24.5 and 18.9 months, respectively. Two patients had complete remission (CR), 8 partial response (PR) and 14 no change (NC), which resulted in an RR of 28%. The MST according to the responses of CR/PR, NC and progressive disease (PD) patients was 45.5, 20.2 and 11.2 months, respectively. Severe toxicity (grades 3 or 4) to this regimen occured only in 0-10% of the cases, and there were no treatment-related deaths. Conclusion: There was no difference in response and survival between HAI and SI, which could be interpreted as a favorable result. Regardless of the route of administration, low-dose LV/5-FU treatment should be considered for patients with liver metastasis from CRC.