title: Safe use of FOLFOX in two patients with metastatic colorectal carcinoma and severe hepatic dysfunction.
abstract: BACKGROUND
  Chemotherapeutic options for patients with metastasised colorectal cancer and impaired liver function are limited. Although oxaliplatin and 5-FU are well tolerated as single therapeutic agents, data supporting their use as combination chemotherapy in the setting of severe hepatic dysfunction are insufficient.
  
  
  METHODS
  Here, we report on 2 patients with colorectal cancer and severe liver dysfunction secondary to hepatic metastases. On admission both patients displayed a bilirubin of > 22 mg/dL and an alkaline phosphatase (AP) of > 350 U/L as signs of extensive hepatic tumor spread. We initiated a 5-FU/oxaliplatin-based combination chemotherapy in both patients.
  
  
  RESULTS
  Liver function and clinical performance improved dramatically within the first cycles of therapy in both patients. On radiologic evaluation, we observed 1 partial response and one long-term (10 months) disease stabilization. The toxicity was acceptable in both patients.
  
  
  CONCLUSIONS
  We concluded that oxaliplatin-based combination chemotherapies (eg FOLFOX4) may achieve good tumor response without significant side effects in patients with metastatic colorectal cancer and hepatic dysfunction.
authors: Department of Medicine III, University of Aachen, Germany.
authors: Christoph
authors: C
authors: Roderburg
authors: Nicole
authors: N
authors: do O
authors: Roland
authors: R
authors: Fuchs
authors: Jhenee
authors: J
authors: Bubenzer
authors: Michael
authors: M
authors: Spannbauer
authors: Tom
authors: T
authors: Luedde
authors: Christian
authors: C
authors: Trautwein
authors: Jens J W
authors: JJ
authors: Tischendorf