From the FDA Drug Label
DOSAGE AND ADMINISTRATION The recommended dose of XELODA is 1250 mg/m2 administered orally twice daily (morning and evening; equivalent to 2500 mg/m2 total daily dose) for 2 weeks followed by a 1-week rest period given as 3-week cycles. The dosage of capecitabine for nasopharyngeal carcinoma is 1250 mg/m2 administered orally twice daily for 2 weeks followed by a 1-week rest period.
- The rest period is 1 week. 1
From the Research
Capecitabine for nasopharyngeal carcinoma is typically administered at a dose of 650 mg/m² twice daily for 1 year, as metronomic adjuvant therapy, which has been shown to significantly improve failure-free survival with a manageable safety profile 2.
Key Considerations
- The most recent and highest quality study, published in 2021, supports the use of metronomic capecitabine as adjuvant therapy in locoregionally advanced nasopharyngeal carcinoma, with a dose of 650 mg/m² twice daily for 1 year 2.
- This regimen has been shown to improve failure-free survival and reduce the risk of recurrence and death, with a manageable safety profile 2.
- The rest period is crucial to allow normal cells to recover from the cytotoxic effects of the medication, reducing side effects like hand-foot syndrome, diarrhea, and myelosuppression.
- Capecitabine works as a prodrug that converts to 5-fluorouracil in tumor tissues, interfering with DNA synthesis and inhibiting cancer cell growth.
- Adequate hydration and prompt management of side effects are essential during treatment.
- Dosage may need adjustment based on individual patient factors including renal function, body surface area, and tolerance to treatment.
- Regular monitoring of blood counts and liver function is recommended throughout the treatment course.
Comparison with Other Regimens
- Other studies have investigated the use of capecitabine in combination with other treatments, such as cisplatin and docetaxel, with varying doses and schedules 3, 4, 5.
- However, the metronomic adjuvant therapy regimen with capecitabine has been shown to be effective and well-tolerated, with a significant improvement in failure-free survival 2.
Quality of Life and Toxicity
- The use of capecitabine in combination with cisplatin has been shown to improve the quality of life and reduce toxic and side effects in patients with local nasopharyngeal carcinoma 6.
- The metronomic adjuvant therapy regimen with capecitabine has also been shown to have a manageable safety profile, with grade 3 adverse events reported in 17% of patients 2.