大多数接受肝动脉输注 (HAI) 氟尿苷标准剂量方案 (SDP) 治疗的患者需要保持和减少剂量，从而限制了他们的 HAI 治疗。我们假设，减少氟尿嘧啶核苷起始剂量的修改剂量方案（MDP）将减少剂量保持和剂量减少，并且具有类似的潜力将不可切除的结直肠肝转移（uCRLM）患者转变为切除术。我们回顾了我们的患者机构数据库uCRLM 在 2016 年至 2022 年间接受 HAI 治疗。2019 年，我们将氟尿苷起始剂量修改为 SDP (0.12 mg/kg) 的 50% (0.06 mg/kg)。我们比较了 SDP 和 MDP 队列之间的治疗相关结果。在 33 名患者中，15 名 (45%) 接受了 SDP 治疗，18 名 (55%) 接受了我们新机构的 MDP 治疗。 MDP 队列在剂量减少前完成了更多的周期（平均 4.2 对 2），接受了更多的总周期（中位数 7.5 对 5），并且平均治疗天数多了 39 天（所有 P < 0.05）。 SDP 经历了更多的剂量减少（1.4 vs. 0.61）和剂量保持（1.2 vs. 0.2；均 P < 0.01）。在每组可能转为肝切除的患者中，SDP 组中的 3 名患者（23%）和 MDP 组中的 6 名患者（35%）转为切除（P = 0.691）。总体而言，SDP 中的 4 名患者 (27%) 进行了治疗，结束了胆道毒性，而 MDP 中只有 1 名患者 (6%) 进行了治疗。HAI 氟尿苷起始剂量的 50% 提供了更少的治疗中断、更连续的氟尿苷周期和类似的潜力将最初使用 uCRLM 的患者转变为疾病清除。© 2024。外科肿瘤学会。

Most patients treated with the standard dosing protocol (SDP) of hepatic arterial infusion (HAI) floxuridine require dose holds and reductions, thereby limiting their HAI therapy. We hypothesized that a modified dosing protocol (MDP) with a reduced floxuridine starting dose would decrease dose holds, dose reductions, and have similar potential to convert patients with unresectable colorectal liver metastases (uCRLM) to resection.We reviewed our institutional database of patients with uCRLM treated with HAI between 2016 and 2022. In 2019, we modified the floxuridine starting dose to 50% (0.06 mg/kg) of the SDP (0.12 mg/kg). We compared treatment related outcomes between the SDP and MDP cohorts.Of n = 33 patients, 15 (45%) were treated on the SDP and 18 (55%) with our new institutional MDP. The MDP cohort completed more cycles before a dose reduction (mean 4.2 vs. 2), received more overall cycles (median 7.5 vs. 5), and averaged 39 more days of treatment (all P < 0.05). The SDP experienced more dose reductions (1.4 vs. 0.61) and dose holds (1.2 vs. 0.2; both P < 0.01). Of the patients in each group potentially convertible to hepatic resection, three patients (23%) in the SDP and six patients (35%) in the MDP group converted to resection (P = 0.691). Overall, four patients (27%) in the SDP developed treatment ending biliary toxicity compared with one patient (6%) in the MDP.A 50% starting dose of HAI floxuridine provides fewer treatment disruptions, more consecutive floxuridine cycles, and a similar potential to convert patients with initially uCRLM for disease clearance.© 2024. Society of Surgical Oncology.