or 10 mg/m2 per day, p.o or i.v 1-14 days to 5 mg/m2 night , p.o or i.v., day 15 to 21 VCR 1.5 mg/m2 , i.v. , days 1, 8 and 15 DNR : 30 mg/m2 , i.v. , 1, 2 , 8 and 9 CFM and 600 mg/m2 day , i.v. , days 1 and 15 L -ASA E. coli ( Kidrolase ® ) : 10,000 IU/m2 i.m. or i.v., on days 1-4 and 15-18 .