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Incorporation of cytotoxic drugs into microspheres reduces but does not eliminate systemic toxicity. The extent of liver to lung shunt was measured in 26 patients with colorectal liver metastasis. Liver to lung shunting correlated with proportion of liver replacement but did not exceed 4.4% and therefore is unlikely to cause systemic toxicity.

Is liver to lung shunting in colorectal liver metastasis the cause of toxicity following treatment with cytotoxic microsphere aggregates?