CRguy wrote:Just as an FYI from 2007.
with neoadjuvant chemoradiation I did 1800 mg twice daily ( 15 minutes after food )
...
Adjuvant Xeloda post surgery :
2,000 - 2,500 mg twice daily ( 15 minutes after food )
...
You mentioned "2000 mg per day" is that only once per day ?
Best wishes
CRguy
CRguy wrote:The reason I asked about your dosing is that 2,000 mg total daily dose seems low, BUTT you are also on Avastin ???
Xeloda has a variable dosing schedule for body size, age, chemo protocol specifications etc.
and many protocols can differ between treatment centers and from country to country.
Beckster wrote:... by the 4th cycle, I developed hand/foot syndrome. Instead of lowering my dose, he had me take 3000 mg for 12 days instead if 14 days with 9 days off. This small decrease really helped the peeling and burning in my hands and feet. I did Xeloda for 6 months without interruption. He did give me the option for 5 days on and 2 days off, but I opted for the 2 week schedule.
behconsult wrote:Dr. Saab stated Europeans do better with it than Americans.
zephyr wrote:There have been several threads about xeloda but I can't find where there's a discussion about different timing schedules. It appears that most people are on cycles of 2-3 weeks on and then a week off. Has anyone been on a shorter cycle and then changed to a longer one - or vice versa? I'm getting ready to begin and my schedule is 2000 mg per day, 5 days on, 2 days off. I'm wondering if the shorter period on the front end will make it more tolerable but I'm also wondering if 2 days is enough time to recover. Thoughts anyone? I know everyone's different but I'm trying to be more prepared this time around with chemo.
Thanks in advance.
CRguy wrote:behconsult wrote:Dr. Saab stated Europeans do better with it than Americans.
Which may .... have to do with folic acid supplementation of just about EVERYTHING in North America
... leading to an increase in toxicities.
Best wishes
CRguy
WriterGirl1969 wrote:What I uncovered in several different medical reports from various sources was essentially that Xeloda was found to reach maximum efficiency at 8 days. Anything beyond that increased side-effects without increasing any benefit.
WriterGirl1969 wrote:...I took Xeloda (by mouth) mono-therapy in 2016 following my surgery. I was on the normal cycle of 2 weeks on, 1 week off for the first 5 months, but was beginning to see a build-up in the side-effects, so I went digging. What I uncovered in several different medical reports from various sources was essentially that Xeloda was found to reach maximum efficiency at 8 days. Anything beyond that increased side-effects without increasing any benefit.
Here's the link to this study: https://www.nature.com/articles/npjbcancer20166
"...observed that the maximum effect of capecitabine is reached at ~8 days. Therefore, further dosing through day 14 contributes to toxicity without enhancing efficacy."
This finding is what has led many providers to move to the 1 week on / 1 week off method, especially for those experiencing side effect difficulties. ...several people here on the forum ... had just as much success with it as anyone.
...my oncologist felt unwilling to deviate from "the book" on treatment. I ...moved to the 1/1 regimen anyway, finished treatment, and promptly got myself a new oncologist. I am about to have my 3-year scans, but so far I remain NED.
zephyr wrote:...Has anyone been on a shorter cycle and then changed to a longer one - or vice versa? I'm getting ready to begin and my schedule is 2000 mg per day, 5 days on, 2 days off. I'm wondering if the shorter period on the front end will make it more tolerable but I'm also wondering if 2 days is enough time to recover. Thoughts anyone? I know everyone's different but I'm trying to be more prepared this time around with chemo.
CRguy wrote:behconsult wrote:Dr. Saab stated Europeans do better with it than Americans.
Which may .... have to do with folic acid supplementation of just about EVERYTHING in North America
... leading to an increase in toxicities.
Best wishes
CRguy
The US has an aggressive policy of fortifying food with folic acid, and requires that all flour, rice, pasta, cornmeal and other grain products are enriched with 140 μg folic acid per 100 g. Similar programs have been initiated in Canada and a number of countries in South America and the Middle East, but are unusual in Europe. One could speculate, therefore, that folic acid supplementation could be a major factor contributing to the perceived excess capecitabine toxicity noted in the US.
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