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Find out what ECF is, how you have it and other important information about having ECF.

ECF is the name of a chemotherapy combination. It includes the drugs: 

  • E – epirubicin
  • C – cisplatin
  • F – fluorouracil (5FU)

It is treatment for stomach cancer and cancer of the food pipe (oesophagus).

How ECF works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have ECF

You have these drugs into your bloodstream, usually through a long line: a central line, a PICC line or a portacath.

These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of your treatment.

When you have it

You have ECF chemotherapy as cycles of treatment, each lasting 3 weeks (21 days). You might have between 3 and 8 cycles. Your treatment plan depends on the type of cancer you have.

On the first day of the cycle you have
  • epirubicin as an injection into your bloodstream (intravenously)
  • cisplatin as a drip into your bloodstream over 1 to 4 hours
  • extra fluids through a drip before and after the cisplatin to protect your kidneys
  • fluorouracil as a drip through a pump for either 4 days or continuously for 21 days

The fluorouracil pump might be a small portable one if you have a long line. This means that you can go home with it. You then go back to the hospital for the nurses to refill or disconnect it. Your doctor or nurse will tell you when you need to go back.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

DPD deficiency

Around 5 out of 100 people (5%) have low levels of an enzyme called DPD in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from fluorouracil. It doesn’t cause symptoms so you won’t know if you have a deficiency. Contact your doctor if your side effects are severe.

Other medicines, food and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.


Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.


Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.


You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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