What Is FLOT Chemotherapy?

FLOT may be used around surgery for some stomach cancers. It is also used for cancers of the gastroesophageal junction, where the food pipe meets the stomach. FLOT combines several chemotherapy drugs. That makes side-effect planning, and timing around surgery, especially important.

Regimen names can look like alphabet soup. They usually pack together drug initials, timing, and sometimes the order of treatment. Use a page like this to learn what the name means. Then ask how your own team's version applies to you.

A care team may raise FLOT while planning treatment before and after surgery for certain stomach or gastroesophageal junction cancers.

The same regimen name can be used in different situations. Doses and schedules vary too. Do not use this page to work out doses, change medicines, or compare your plan with someone else's.

Before a regimen begins, the team checks a great deal. That can include pathology, stage, biomarkers, organ function, blood counts, and infection risk. It can also include your medicines, allergies, fertility concerns, and whether a port or PICC line would help. Some regimens also call for anti-nausea medicines, steroid instructions, a hydration plan, heart tests, or neuropathy checks.

• What are the names of each drug in my regimen?
• How many cycles are planned, and what would change that plan?
• Which side effects are common, and which are urgent?
• Will I need growth-factor shots, transfusions, or infection precautions?
• How will we know whether it is working?
• What happens if side effects force a delay or dose change?

Ask about low blood counts, infection, diarrhea, mouth sores, neuropathy, nausea, fatigue, and kidney function. Ask when to call.

Your care team knows which side effects matter most for your exact regimen, doses, and health history. Get the after-hours number and the fever rules before the first infusion.

Sometimes two regimens offer similar benefits with different trade-offs. Ask what the alternatives are, and why this plan is preferred. Ask whether a clinical trial fits. Ask whether a second opinion should happen before treatment begins.

• Call 911 or go to an emergency department if your throat tightens, your face or tongue swells, or you cannot get a proper breath during an infusion or in the hours after one. Two of the FLOT drugs, docetaxel and oxaliplatin, can set off a severe allergic reaction within minutes.
• Ring your FLOT team immediately, day or night, if you record a temperature of 100.4°F (38°C) or higher, or you get shaking chills. FLOT drops white cells, and the CDC treats a fever during chemotherapy as a medical emergency. Do not sit on it until morning. If nobody answers quickly, go to an emergency department and tell them you are on FLOT chemotherapy.
• Call your care team the same day if loose stools keep coming after a day on the anti-diarrhea plan you were given, or nothing you drink stays down.
• Call your care team within a day or two if numbness or tingling in your hands or feet starts to get in the way of buttons, keys or stairs. Oxaliplatin doses are often changed early to keep nerve damage from settling in.

Start with Chemotherapy, How Chemotherapy Is Given, What to Bring to Chemotherapy, and Low White Blood Cells During Chemotherapy.

• DailyMed — Oxaliplatin injection label
• CDC — Fever and Cancer Treatment
• NCI — Infection and Neutropenia During Cancer Treatment
• NCI — Nerve Problems (Peripheral Neuropathy) and Cancer Treatment