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What is FLOT Chemotherapy

 Please be advised, i am not a doctor, or medical profeccional. All blogs are written from our own experiences and research. Your treatment may be different than what is written here.

What is FLOT Chemotherapy?

FLOT chemotherapy is a treatment regimen primarily used for gastroesophageal cancers, including stomach cancer (gastric cancer) and esophageal cancer. It is often given before and after surgery to shrink the tumor, improve the chances of successful removal, and reduce the risk of recurrence.

The name FLOT comes from the four chemotherapy drugs used in this regimen:

  • F – 5-Fluorouracil (5-FU)

  • L – Leucovorin (folinic acid)

  • O – Oxaliplatin

  • T – Docetaxel (Taxotere)

This combination has been found to be more effective than older regimens such as ECF (epirubicin, cisplatin, and 5-FU) in improving survival rates for patients with operable gastric or gastroesophageal junction cancers.

How Does FLOT Chemotherapy Work?

FLOT works by targeting and killing rapidly dividing cancer cells, preventing them from growing and spreading. Each drug plays a specific role:

  • 5-Fluorouracil (5-FU) – Interferes with DNA synthesis, preventing cancer cells from multiplying.

  • Leucovorin – Enhances the effectiveness of 5-FU.

  • Oxaliplatin – A platinum-based drug that damages cancer cell DNA, leading to cell death.

  • Docetaxel – Disrupts the cell division process, causing cancer cells to die.

This combination is particularly effective in shrinking tumors before surgery (neoadjuvant therapy) and reducing the risk of cancer returning after surgery (adjuvant therapy).

What to Expect During FLOT Treatment?

FLOT chemotherapy is typically given in cycles every two weeks. A full course usually consists of 4 cycles before surgery and 4 cycles after surgery, totaling 8 cycles.

Each cycle follows this pattern:

  1. Day 1: Three drugs (Docetaxel, Oxaliplatin, Leucovorin)  are administered via intravenous infusion (IV) in a hospital or clinic.

  2. Days 2-14: The patient goes home with a portable 5-FU infusion pump, which delivers the drug continuously over 24 hours.

  3. Day 15: The next cycle begins if blood counts and overall health allow.

Throughout treatment, patients have regular blood tests and medical assessments to monitor their body's response and manage side effects.

Common Side Effects of FLOT Chemotherapy

While FLOT is effective, it also comes with side effects. These can vary from mild to severe, and doctors will closely monitor patients for any complications.

Short-Term Side Effects:

  • Nausea and vomiting – Managed with anti-nausea medications.

  • Diarrhea or constipation – May require dietary adjustments or medications.

  • Fatigue – One of the most common side effects.

  • Mouth sores (mucositis) – Can make eating and drinking painful.

  • Neuropathy (nerve damage) – Tingling, numbness, or pain in hands and feet, especially from Oxaliplatin.

  • Hair loss – Due to Docetaxel.

  • Loss of appetite and weight loss – Nutrition support may be necessary.

  • Increased risk of infections – Due to low white blood cell counts.

Long-Term Side Effects:

  • Peripheral neuropathy – In some cases, nerve damage from Oxaliplatin may persist even after treatment ends.

  • Heart complications – Rare but possible effects from 5-FU.

Doctors manage side effects through medications, lifestyle adjustments, and supportive care to help patients complete their treatment successfully.

Tips for Managing FLOT Chemotherapy Side Effects

  • Stay hydrated and eat small, nutritious meals to help with nausea and appetite loss.

  • Avoid extreme temperatures (hot or cold) to minimize neuropathy and prevent laryngeal spasms.

  • Practice good oral hygiene to prevent mouth sores.

  • Rest frequently and listen to your body to combat fatigue.

  • Monitor for infections (fever, chills) and report symptoms immediately.

FLOT chemotherapy is a powerful and effective treatment for gastroesophageal cancers, significantly improving survival rates when used before and after surgery. However, it comes with a range of side effects that can require careful management. If you or a loved one are undergoing FLOT treatment, staying informed, working closely with your oncology team, and practicing good self-care can make a significant difference in the journey toward recovery.

Always consult your doctor for personalized advice regarding your treatment and how to manage any side effects effectively.

Have you or someone you know undergone FLOT chemotherapy? Share your experiences or questions in the comments below to help support others going through similar treatments.




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