FOLFOX

FOLFOX is a chemotherapy regimen for treatment of colorectal cancer, made up of the drugs

Adjuvant treatment in patients with stage III colon cancer is recommended for 12 cycles, every 2 weeks. The recommended dose schedule given every two weeks is as follows:

Day 1: Oxaliplatin 85 mg/m² IV infusion in 250-500 mL D5W and leucovorin 200 mg/m² IV infusion in D5W both given over 120 minutes at the same time in separate bags using a Y-line, followed by 5-FU 400 mg/m² IV bolus given over 2–4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.

Day 2: Leucovorin 200 mg/m² IV infusion over 120 minutes, followed by 5-FU 400 mg/m² IV bolus given over 2–4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.

Premedication with antiemetics, including 5-HT3 blockers with or without dexamethasone, is recommended.

The dose schedule given every two weeks is as follows:

Day 1–2: Oxaliplatin 100 mg/m² IV infusion, given as a 120 minutes IV infusion in 500 mL D5W, concurrent with leucovorin 400 mg/m² (or levoleucovorin 200 mg/m²) IV infusion, followed by 5-FU 400 mg/m² IV bolus, followed by 46-hour 5-FU infusion (2400 mg/m² for first two cycles, increased to 3000 mg/m² in case of no toxicity > grade 1 during the first two cycles).

Days 3–14: Rest days

Antiemetic prophylaxis with 5-HT3-receptor antagonist.

FOLFOX is given directly into the bloodstream through an intravenous line. It can be given through a thin, short tube (a cannula) put into a vein in the arm each time one has a treatment. It may also be given 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 the chest. The tube can stay in place throughout the treatment.

Chemotherapy can be given as cycles of treatment. The number of cycles depends on the situation but may be up to 12. Each treatment cycle lasts 2 weeks.

On the first day oxaliplatin is given through a drip over 2 hours. Folinic acid is given concurrently. This followed by an injection of fluorouracil into the cannula or central line. An infusion of 5FU is then started through a drip or pump, which lasts for 22 hours.

On the second day folinic acid is given as an injection or through a drip for 2 hours. This is followed by an injection of fluorouracil, followed by another fluorouracil infusion through a drip or pump for 22 hours.

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