Find out about what EOX is, how you have it and other important information about having EOX.
EOX is the name of a chemotherapy combination. It includes the drugs:
- E – epirubicin
- O – oxaliplatin
- C – capecitabine (Xeloda)
It is treatment for:
- gastro oesophageal cancer – the junction of the stomach and oesophagus
- oesophageal cancer
- stomach cancer
How EOX works
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
How you have EOX
- capecitabine as a tablet - you take it twice a day, morning and night, swallow it whole with plenty of water, speak to your pharmacist if you have problems swallowing the tablets
- epirubicin as an injection into your bloodstream (intravenously) once each cycle
- oxaliplatin as a drip into your bloodstream over 2 hours once each cycle
Into your bloodstream
You have oxaliplatin and epirubicin into your bloodstream. You can have these drugs through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you might have them through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.
Taking your tablets or capsules
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your specialist or advice line before you stop taking a cancer drug.
When you have it
You have EOX chemotherapy as cycles of treatment each lasting 3 weeks. Depending on your needs, you may have up to 8 cycles, taking around 6 months in total.
You have each cycle of treatment in the following way:
- epirubicin as an injection into your vein
- oxaliplatin as a drip for 2 hours into the bloodstream
- take capecitabine tablet morning and evening
- take capecitabine tablets morning and evening
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.
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.
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.
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.
Don’t breastfeed during this treatment because the drugs may come through in your breast milk.
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 capecitabine. These side effects can rarely be life threatening. It doesn’t cause symptoms so you won’t know if you have a deficiency. Talk to your doctor if you are worried and about whether you need to have a test to check for it.
Contact your doctor if your side effects are severe.
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.
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).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)
- 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 oral polio or the typhoid vaccine.
This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.
You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened.
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.