XELOX chemotherapy is a combination treatment regimen used in cancer care. It integrates two distinct anti-cancer drugs, working together to target and reduce cancer cells. This common strategy enhances effectiveness and addresses cancer in different ways.
Understanding XELOX Chemotherapy
XELOX is an acronym representing two specific chemotherapy drugs: Xeloda, which is the brand name for capecitabine, and oxaliplatin. Capecitabine is an oral prodrug of 5-fluorouracil, meaning it is converted into the active chemotherapy agent within the body, primarily at the tumor site. Oxaliplatin is a platinum-based chemotherapy drug administered intravenously.
These medications work by interfering with the processes of cancer cell growth and division. Capecitabine, once converted to 5-fluorouracil, disrupts DNA synthesis in rapidly dividing cells, preventing their replication. Oxaliplatin forms cross-links in the DNA of cancer cells, which also prevents DNA replication and transcription.
XELOX is commonly used to treat various types of cancer, with a primary indication for advanced or metastatic colorectal cancer. It can be used as an initial therapy or as an adjuvant treatment following surgery for stage III colon cancer. The regimen is also sometimes utilized for other gastrointestinal cancers, such as gastric (stomach) and esophageal cancers.
Treatment Schedule and Administration
XELOX chemotherapy is typically administered in cycles, with each cycle lasting 21 days. This cyclical approach allows for periods of treatment followed by rest, enabling the body to recover. The specific number of cycles a patient receives varies based on the type and stage of cancer, as well as the individual’s response to treatment.
Within each 21-day cycle, oxaliplatin is given as an intravenous (IV) infusion, typically on Day 1. This infusion usually takes about 2 hours to complete and is administered in a clinic or hospital setting. Patients may receive supportive medications, such as dexamethasone and ondansetron, before the oxaliplatin infusion to help reduce potential side effects like nausea.
Capecitabine is taken orally at home. Patients typically take capecitabine tablets twice daily, usually within 30 minutes after a meal, for the first 14 days of each 21-day cycle. Following these 14 days, there is a 7-day rest period (Days 15-21), allowing the body to recover before the next cycle.
Managing Side Effects
Patients undergoing XELOX chemotherapy may experience various side effects. Nausea and vomiting are common, but they are often managed with anti-nausea medications prescribed by the healthcare team. Diarrhea is another frequent side effect, particularly with capecitabine, and can be managed with anti-diarrheal medications like loperamide and by adjusting diet, such as avoiding spicy or high-fiber foods and dairy products.
Hand-foot syndrome is a skin reaction that can occur with capecitabine. Symptoms include redness, swelling, pain, tingling, and peeling on the palms of the hands and soles of the feet. Regular moisturizing, avoiding hot water, and wearing comfortable footwear can help manage these symptoms.
Peripheral neuropathy, characterized by numbness, tingling, or pain in the hands and feet, is a common side effect associated with oxaliplatin. This sensation can sometimes be exacerbated by cold temperatures, so patients are often advised to avoid cold food, drinks, and exposure to cold. It is important to report these sensations to the healthcare team, as dose adjustments may be considered.
Fatigue is a common side effect of XELOX. Low blood counts, including a reduction in white blood cells (increasing infection risk), red blood cells (leading to anemia), and platelets (increasing bruising and bleeding risk), are also potential side effects. Patients are monitored with regular blood tests, and any fever or signs of infection should be reported immediately.
Communication with the healthcare team about any side effects experienced is important for appropriate management.