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Folfox vs. Folfiri

Posts: 398
Joined: Apr 2018

I have completed 6 cycles of FolFox and have neuropathy in fingers that I am afraid may be permanent, I am hoping to switch to FolFiri--is there any diffference in their efficacy? I went for seond opinion at Mayo and the rather cold hearted oncologist told me he steers away from Oxiliplatin , says it is what the "older" docs use, That irinitecan is just as effective --I  am aware you can lose your hair temporarily-but that to me sure beats permanent neuropathy. Do you lose oll of your hair, like eyelashes and eyebrows too? My concern is will it work as well? The FolFox did shrink my tumors by almost half---so confused and my doctors are not the most compassionate. Any thoughts?? This forum is the only place I have found to answer so many questions, thank you all!!

Posts: 235
Joined: Jan 2018

After 23 cycles of Folfri, my huband still has hair, granted it's thin it's still there. The loss was very gradual and frankly if you didn't know him you would just think it was age related and not cancer. He had to stop the Oxi too. 


Posts: 54
Joined: Aug 2018

They both have side effects.  I did 3 rounds of folfox before liver resection surgery and 11 rounds of folfiri+vectibix after.  My oncologist is Dr. Nancy Kemeny at MSK who, in my opinion, is an absolute genius so if she's okay with folfiri it must be okay.  With folfox I had issues with eating/swallowing (first bite, throat spasms with cold stuff, etc).  With folfiri I had a really strange nauseous feeling for an hour or two after infusion - almost like I was incredibly intoxicated.  My hair thinned a bit on forfiri, but not enough for other people to notice.  Not sure if the folfiri or vectibix caused it, but my lower eyelashes fell completely out and my upper eyelashes grew so long I had to keep cutting them (I mean ridiculous long).


Posts: 163
Joined: Apr 2017

The Ox does increase effectiveness which is why they give it out, however each person is different.  I didn’t lose my hair at all with either  chemo.  My Onc told me I would, but didn’t happen, each case is different.  The frustratrating thing with cancer is, the doctors can tell you what might happen, but they don’t ever know what WILL happen.  That’s why it’s such a tough disease. 

abita's picture
Posts: 1010
Joined: Dec 2017

I lost more hair on Folfox than folfiri. Before my surgery, 4 rounds of Folfox shrunk my tumors by almost half. After my surgery, I had a reaction to oxaliplatin, so switched to folfiri. There was no way to tell if it was working because I had the surgery to remove my tumors. But, at my 6 week scan, I had two new tumors in my liver. I am currently in the hospital getting desensitized to oxaliplatin so that I can take it since we know it shrinks my tumors. About to leave, had no reaction.

I had a lot of hair on my head, lost about 2/3rds but still have enough that no wig. My lashes did thin out. Lost all my leg, underarm, and arm hair. My head hair started growing back right after I stopped chemo, but still don't have to shave. My eyelashes also just grew back. Guessing that this next round will make me lose the rest of my hair. Just had a visit from the wig lady.

Posts: 398
Joined: Apr 2018

Thanks everyone!  Not sure if I should try and tough out a couple more rounds of Folfox or switch--since the Folfox did shrink the tumors. But then again maybe its the 5Fu shrinking them? I have been off chemo for 6 weeks dealing with this port so maybe my body has recovered enough to take a bit more Oxiiliplatin. MountainHiker I have the exact same symptoms with Oxi!  

Posts: 13
Joined: Aug 2017

I had almost 50 cycles of FOLFIRI  My hair did thin out but it wasn't that noticeable because I wear it in a quarter-inch buzz cut. The fatigue was the most troublesome side-effect.

I am currently on FOLFOX, the FOLFIRI having lost its effectiveness, and have gone through 5 cycles. I have not noticed any hair loss. I do have First Bite Syndrome, painful tears, and some cold sensitivity. No peripheral neuropathy so far. My oncologist is thinking of stopping the FOLFOX after six cycles and putting me on a maintenance chemotherapy regimen. If I still don't have signs of neuropathy, I might try to convince him to go for a little more FOLFOX. My cancer is incurable, so if a couple more rounds can beat it back a little more, I'm willing to go for it.



JanJan63's picture
Posts: 2482
Joined: Sep 2014

I hated being on Folfox with the oxypalatin. It was miserable and likely caused the blood clot that almost killed me. I will never be on it again. I'd been going to tell my onc that I couldn't tolerate it but then I had the blood clot and that was the end of it anyway.

I have not lost my hair at all. Its as thick as ever. But the chemo that I go on now- Vectibix- oddly causes hair growth so that my eyelashes get long, my eyebrows get think, and I grow a small moustache and goatee. When I'm done all the rounds it all falls out, including the eyelashes. Today I have eyelashes but they're sparse and almost no body hair. Shaving my legs means trying to find a hair to be shaved. Same with armpits. I like that part of it all.


Trubrit's picture
Posts: 5417
Joined: Jan 2013

I lost most of my hair, all over.   

I remember feeling my skin, it felt like silk when the hair was gone. 

And, not all of the hair grew back. My legs and armpits, and my lady parts are all pretty light on the hair, now.  My head hair grew back thick and curly, then that fell out, and I have less - but enough - hair, but it is dead straight. My hair was never straight. Oh well! Rather have straight hair than no hair. 

I have permanent neuropathy in my hands, legs and feet.  

FOLFOX was definitely harsh on my body, but I have been NED for over four years. 

Good luck! 


Annabelle41415's picture
Posts: 6694
Joined: Feb 2009

It's a hard drug, and I've got neuropathy from it but can't tell you the difference between the two.  My hair thinned but never lost it all and most people didn't even know it was thinning.  Oxi is harder with coldness and just hated that because my treatment was during the winter.  I'm sure that treatment has changed since going through it, but it's got to be a decision that you feel comfortable with.  Maybe you want to look into getting a second opinion.  If the doctor is good, then bedside manners sometimes don't matter.


Posts: 253
Joined: Jul 2017

I think it is really effective because it also shrunk my lung met last year to more than half when I still had the met.  I wanted to avoid the oxy this time but doing mop-up chemo now to avoid another recurrence and so far the side effects are quite manageable--just loss of appetite and numbness of hands that go away after infusion (the hardest side effect I have to deal with is mental torture but as they say, the side effects differ from person to person).  My doc mentioned about folfiri but since I still work, I want to preserve the hair so I just went with the folfox combo.  Good luck on whatever combo you choose and good luck to your succeeding treatments.  We can do this!

And oh, my doc mentioned that the folfiri is as effective.

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