What is the recommended duration to withhold FOLFOX (Folinic acid, Fluorouracil, Oxaliplatin) before surgery?

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Last updated: February 18, 2025View editorial policy

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From the Guidelines

Recommended Duration to Withhold FOLFOX Before Surgery

FOLFOX should be held for a minimum of 4 weeks prior to surgery to minimize potential surgical complications 1.

  • The recommended duration of FOLFOX treatment prior to surgery is 6-8 cycles, with the last cycle administered at least 4 weeks before the planned surgical date 1.
  • This interval allows for adequate recovery from the myelosuppressive and neurotoxic effects of oxaliplatin, reducing the risk of postoperative morbidity.
  • It is also recommended to discontinue oxaliplatin from FOLFOX after 3 months of therapy, or sooner for unacceptable neurotoxicity, with other drugs in the regimen maintained for the entire 6 months or until tumor progression 1.
  • Patients experiencing neurotoxicity on oxaliplatin should not receive subsequent oxaliplatin therapy until and unless they experience near-total resolution of that neurotoxicity 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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