Table 1:
Algorithm for HAI FUDR dose reduction
| Liver enzymes | Reference Value | % FUDR Dose |
|---|---|---|
|
| ||
| AST (at pump emptying or day of planned re-treatment, whichever is higher) | 0 to <2 x reference value | 100% |
| 2 to <3 x reference value | 80% | |
| 3 to < 4 x reference value | 50% | |
| > 4 x reference value | Hold | |
|
| ||
| Alk Phos (at pump emptying or day of planned re-treatment, whichever is higher) | 0 to < 1.2 x reference value | 100% |
| 1.2 to <1.5 x reference value | 50% | |
| >1.5 x reference value | Hold | |
|
| ||
| Tbili (at pump emptying or day of planned re-treatment, whichever is higher) | 0 to < 1.2 x reference value | 100% |
| 1.2 to <1.5 x reference value | 50% | |
| >1.5 x reference value | Hold | |
|
| ||
|
| ||
| Recommencing FUDR treatment after Hold | ||
|
| ||
| Reason for Treatment Delay | FUDR resumed when value has returned to: | % FUDR dose |
|
| ||
| AST elevation | 2 x reference value | 25% of last dose |
|
| ||
| Alk phos elevation | 1.2 x reference value | 25% of last dose |
|
| ||
| Tbili elevation | 1.2 x reference value | 25% of last dose |
HAI, hepatic arterial infusion; FUDR, floxuridine; AST, aspartate aminotransferase; Alk phos, alkaline phosphatase; Tbili, total bilirubin.