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This page tells you about the chemotherapy drug combination TPF and its possible side effects. There is information about


What TPF is

TPF is the name of a combination of chemotherapy drugs used to treat head and neck cancers. It is made up of the drugs

  • DoceTaxel (also known by its brand name Taxotere)
  • CisPlatin
  • Fluorouracil

How you have TPF

You have TPF drugs into your bloodstream (intravenously). You can have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. The tube stays in place as long as you need it.

You usually have TPF chemotherapy as cycles of treatment. Each cycle lasts 3 weeks. You usually have 3 or 4 cycles, taking 9 to 12 weeks in total. This treatment is usually followed by a course of radiotherapy and then more chemotherapy.

You usually stay in hospital to have TPF for 4 or 5 nights.

You have each treatment cycle in the following way.

For 4 or 5 days you have a drip (continuous infusion) of fluorouracil. On the first day you also have docetaxel for 1 hour and cisplatin for 1 hour. For the next 16 or 17 days you have no treatment. Your next cycle of treatment then starts.

The side effects of a combination of drugs are usually a mixture of those of each drug. The combination may increase or decrease your chance of getting each side effect or it may change the severity. The side effects associated with TPF are listed below. You can use the underlined links to find out more about each one. For general information, see our side effects of cancer drugs section. 


Common side effects

More than 10 in every 100 people have one or more of these effects.

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. Your doctor will check your blood cell levels regularly
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
  • Feeling or being sick affects most people but is usually well controlled with anti sickness medicines. Tell your nurse or doctor if the medicines are not working 
  • Hair loss affects most people and is usually complete hair loss. But the hair will start to grow back once you have finished treatment
  • A sore mouth and throat affects about 7 in 10 people (70%)
  • Tiredness during and after treatment affects 6 out of 10 people (60%) – most people find their energy levels are back to normal within 6 months to a year  
  • Diarrhoea – this is likely to be mild but drink plenty of fluids if you have it
  • Constipation – drink plenty of fluids and let your nurse know if you are constipated for more than 3 days
  • Loss of appetite affects just over 1 in 10 people (10%)
  • Kidney damage – you will have blood tests before treatment to make sure your kidneys are able to cope with the treatment. Your nurse will ask you to drink plenty of water. They will give you fluids through your drip to help flush the drug through
  • A skin rash – you may have some itching and your skin may become sore
  • Loss of taste or a metallic taste
  • Headaches
  • Difficulty sleeping
  • Ringing in the ears (tinnitus) – this nearly always gets better on its own. Some people may have permanent loss of high tone hearing
  • Swelling of areas of the body due to fluid build up (oedema)
  • Shortness of breath
  • Women may stop having periods (amenorrhoea) but this may be temporary
  • Loss of fertility – you may not be able to become pregnant or father a child after this treatment. 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

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these effects.

  • Some people have an allergic reaction while having this treatment, usually at the first or second treatment. Let your treatment team know straight away if you feel hot or have any skin rashes, itching, dizziness, headaches, shivering, breathlessness, anxiety, flushing of the face, or a sudden need to pass urine
  • Brittle, chipped and ridged nails
  • Brown marking on the skin, following the line of the vein where fluorouracil has been injected
  • Soreness, redness and peeling on the palms of the hands and soles of the feet (palmar – plantar syndrome). This may cause tingling, numbness, pain and dryness
  • Numbness or tingling in fingers and toes affects about 4 out of every 100 people (4%). It can cause difficulty with fiddly things such as doing up buttons. This starts within a few days or weeks. It usually goes within a few months of finishing treatment   
  • Damage to heart muscle – this is usually temporary but for a small number of people may be permanent. You will have heart tests before and after your treatment

Rare side effects

Fewer than 1 in 100 people have muscle weakness.


Important points to remember

You may have 1 or 2 or several of the side effects mentioned on this page. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on

  • How many times you've had a drug before
  • Your general health
  • How much of the drug you have (the dose)
  • Other drugs you are having

Coping with side effects

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines 

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Pregnancy and contraception 

These drugs may 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.


Do not breastfeed during this treatment because the drugs may come through in the breast milk.


Related information

On this website you can read about 

Head and neck cancers





Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.

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Updated: 26 August 2014