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EOF

Find out what the chemotherapy combination EOF is, how you have it and other important information about having EOF.

EOF is the name of a combination of chemotherapy drugs. It is made up of:

  • epirubicin
  • oxaliplatin
  • fluorouracil (5FU)

It is a treatment for stomach cancer and cancer of junction between the stomach and the food pipe (gastro oesphageal cancer)

How it works

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

How you have it

You have all EOF drugs into your bloodstream (intravenously).

Drugs into your bloodstream

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have it

You usually have EOF chemotherapy as cycles of treatment. Each cycle of treatment lasts 3 weeks. Depending on your needs, you may have up to 8 cycles, taking about 6 months in total.

You have each cycle of treatment in the following way:

Day 1
  • You have epirubicin as an injection into your vein
  • You have oxaliplatin as a drip into your vein over 2 hours
  • You have fluorouracil (5FU) as a continuous infusion via a portable pump
Day 2 to 21
  • You have fluorouracil (5FU) as a continuous infusion via a portable pump

You then start your next cycle of treatment. You can go home with the 5FU portable pump. But you might need to go back to the hospital every week to have the pump replaced or refilled.

Tests

You have blood tests before 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

Other medicines, foods 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.

DPD deficiency

Between 2 and 8 out of 100 people (2 to 8%) 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. Talk to your doctor if you are worried about it.

Contact your doctor if your side effects are severe.

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're having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

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.

Breastfeeding

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

Treatment for other conditions

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

Immunisations

Having immunisations 

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

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

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)

Contact with others who have had immunisations 

You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

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.

Last reviewed: 
24 Apr 2018
  • Electronic Medicines Compendium

    Accessed April 2018

  • Handbook of Cancer Chemotherapy (8th edition)
    Roland K Keel
    Lippincott Williams and Wilkins, 2012

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
    Public Health England
    First published: March 2013 and regularly updated on the Gov.UK website

  • Report of two protocol planned interim analyses in a randomised multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric cancer receiving ECF

    K Sumpter and others

    British Journal of Cancer, 2005. Vol 92, Pages 1976-1983

  • Capecitabine and Oxaliplatin for Advanced Esophagogastric Cancer
    D Cunningham and others
    The New England Journal of Medicine, 2008. Vol 358, Pages 36-46

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