Caat55 wrote:...Those are the options exactly. The oncologist at Stanford said the the Folfox would be easier on me hands the the Xelox. He seemed to believe there would be less problems with neuropathy. I see the local oncologist on Wednesday and wanted to be better informed for that discussion...
I think that the Stanford oncologist might be right, and here are my reasons:
Whether you do FOLFOX or XELOX, you are expected to get exactly the same total amount of oxaliplatin over the course of the 4 months. The problem is that under XELOX the infusions are given only every 3 weeks, while the FOLFOX infusions are given every 2 weeks. This means that each infusion of oxaliplatin under XELOX has to be 1.5 times the size of the bi-weekly oxaliplatin infusions under FOLFOX. In other words, each time you get a FOLFOX infusion you are getting only 66.6% of what you would be getting at each XELOX infusion. Of course, there are more FOLFOX infusions altogether over the course of 4 months than there are XELOX infusions in order to make up the difference
So, if you are on XELOX, you are hit with an extra wallop of oxaliplatin at each infusion: 1.5 times what you would be receiving if you were on the bi-weekly FOLFOX schedule. So, the short-term toxicity of the infusions will be greater if you are on XELOX. And if you are the kind of patient who is ultra-sensitive to platinum-based drugs, then this difference in level of short-term toxicity can be substantial and could perhaps be cumulative and result in some long-term neuropathy.
Does this make sense?
I had XELOX, not FOLFOX, so I cannot make a personal comparison between the two. All I can say is that I still have periphersl neuropathy, and it has been over 5 years since I had my last infusion of oxaliplatin.