ECF Chemotherapy

ECF chemotherapy comprises of Epirubicin, Cisplatin and 5-Flurouracil and is used as perioperative therapy and in advanced stomach cancer.

They are all given intravenously up to eight cycles are normally given every 21 days or 3 weeks.

The actual number of infusions varies depending on your hospitals policy and also your tolerance of side effects and response to them.

What Is ECF Chemotherapy?

The ECF name is derived from the initials of the 3 drugs used in this regimen:

Epirubicin = E

Cisplatin = C

5-Flurouracil = F

It is normally given through your Hickman, PICC line or Portacath central line.

The 5-Flurouracil is normally given as a slow IV injection or can be given as a drip infusion.

Cisplatin is given as an IV infusion usually over and hour and Epirubicin is normally given as a slow IV injection over 15-20 minutes.

What Are The Side Effects?

ECF chemotherapy does have side effects, some of which are common to other forms of chemo including:

Leucopenia and Neutropenia – a drop in the cells that normally fight off infections in your body

Anemia – a common problem to a lot of cancer chemo regimens and causes tiredness, headaches, breathlessness, muscle aches and pains

Ecchymosis – Bruising problems due to a drop in the numbers of platelet cells or poorly functioning cells

Hair loss and Nail deformities


Diarrhea and vomiting

Neuropathic symptoms – pins and needles or numbness which can occur in your hands and feet

Mucositis or sore mouth

Specific Side Effects Include:

Pink or Red Urine – caused by Epirubicin which is red in color

Kidney Failure – Cisplatin is a nephrotoxic drug and needs to be used with caution and monitoring of your kidney function tests

Myocarditis and Cardiomyopathy – Epirubicin can be cardiotoxic causing damage and heart failure presenting with breathlessness

Pneumonitis – Cisplatin can cause inflammation of the air sacs in your lungs, causing breathlessness and respiratory failure

Are There Any Special Precautions I need to take?

Yes, if you are on ECF chemotherapy you should make sure that you report any fevers, diarrhea or any other symptoms that you develp to your medical team.

Look out for fever particularly around day 10 to 14, but if you develop fever at any other time, you must seek help immediately due to the risk of neutropenia and overwhelming infection developing.

Cleanliness and good oral care is very important too. Make sure that you avoid anyone with infections and make sure that you never have ‘live’ vaccines from your doctor as chemo can cause overwhelming infection occurring.

How Effective Is The Treatment?

Five year survival with ECF chemo is 36% in those who have the treatment perioperatively in comparison to approx. 23% in stomach cancer patients that had surgery only. This represents a 13% benefit which is statistically significant.

It can also be used as palliative chemo with 61% getting some response to the treatment and extending life by just over 4 months.

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