Table 2. . Hepatic arterial infusion floxuridine dose reduction algorithm.

Liver blood test	Values	Values	FUDR dose
AST
Reference range	≤50U/l	>50 U/l
Current value	0 to <3 × ref	0 to < 2 × ref	100%
	3 to < 4 × ref	2 to <3 × ref	80%
	4 to <5 × ref	3 to <4 × ref	50%
	≥5 × ref	≥4 × ref	Hold
If held, restart when	<4 × ref	<3 × ref	50% of last dose
ALP
Reference	≤90U/l	>90 U/l
Current value	0 to < 1.5 × ref	0 to < 1.2 × ref	100%
	1.5 to < 2 × ref	1.2 to < 1.5 × ref	80%
	≥2 × ref	≥1.5 × ref	Hold
If held, restart when	< 1.5 × ref	< 1.2 × ref	25% of last dose
Total bilirubin
Reference	≤1.2 mg/dl	>1.2 mg/dl
Current value	0 to <1.5 × ref	0 to < 1.2 × ref	100%
	1.5 to <2 × ref	1.2 to <1.5 × ref	50%
	≥2 × ref	≥1.5 × ref	Hold
If held, restart when	<1.5 × ref	< 1.2 × ref	25% of last dose

Adapted from [43].