Combination Chemotherapy in Treating Patients With Liver Metastases From Colorectal Cancer

DISEASE CHARACTERISTICS:

• Unresectable liver metastases secondary to colorectal cancer

  • Less than 70% liver involvement on CT scan or MRI

  • Liver biopsy required before study unless 1 of the following conditions are met:

    • Carcinoembryonic antigen greater than 30
    • 5 or more liver metastases visible on CT scan or MRI
    • Greater than 50% to under 70% liver involvement on CT scan or MRI

• Histologically proven primary colorectal cancer that is resected or appears resectable on CT scan and physical exam

  • Documentation of previously resected primaries must be based on pathologic results of the resected tumor

  • Histological documentation of synchronous disease must be based on 1 of the following:

    • Biopsy of primary colorectal tumor before study
    • Suspicious lesion on barium enema, colonoscopy, or sigmoidoscopy, and a liver biopsy positive for adenocarcinoma consistent with the primary colorectal tumor

• Measurable disease

  • Clearly defined liver mass measuring at least 2 cm or at least 3 liver masses on CT scan or MRI
• No evidence of extrahepatic disease on CT scan and physical exam
• No portal vein occlusion or ascites

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Hepatic:

• Bilirubin no greater than 2 times normal

Other:

• No other malignancy within the past 5 years except inactive nonmelanomatous skin cancer, carcinoma in situ of the cervix, or grade 1 bladder cancer
• Not pregnant or nursing
• Fertile patients must use effective contraception

Chemotherapy:

• At least 1 year since prior adjuvant chemotherapy comprising fluorouracil (5-FU) and leucovorin calcium (CF) or 5-FU, CF, and levamisole (LEV)
• At least 6 months since prior adjuvant chemotherapy comprising 5-FU with or without LEV
• No other prior chemotherapy
• No other concurrent chemotherapy

Endocrine therapy:

• No concurrent hormonal therapy except for nondisease-related conditions, e.g.:

  • Steroids for adrenal failure
  • Insulin for diabetes
  • Intermittent dexamethasone as an antiemetic

Radiotherapy:

• No prior radiotherapy to the liver