Switching to chemoradiation (Xeloda + radiation): What to expect?

Posted by ncteacher @ncteacher, Mar 24 7:20pm

To address chemo resistance and hopefully lower my CA 19-9, we are likely going to switch my regimen from modified Folfiri (no oxali) to radiation coupled with capecitabine (Xeloda). Questions:

* I've completed 21 rounds of Folfirinox/Folfiri and have had no side effects with fluorouracil (5-FU). How does capecitabine compare in terms of side effects? I know that capecitabine metabolizes into 5-FU, but I can't tell whether its side effects are similar, better or worse than the 5-FU pump. I'm most concerned about the hand-foot syndrome (blisters, cracking, etc.) that I see listed for capecitabine. How common is that?

* Re radiation, I haven't yet met with radiation oncology, but I'm told the two choices will be a longer series of lower-dose treatments or a round of the high-intensity SBRT regimen. (I'm unsure how many treatments in both regimens.) In winter 2023, I went through 16 rounds of radiation for a DCIS breast cancer. I had no side effects and continued to work and exercise throughout. Would this series of lower-dose treatments be similar? What are the SBRT side effects, and how much stronger are they?

Thanks in advance for any info you can provide.

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

krfinlayson | @krfinlayson | Mar 26 6:12pm

I also took folfirinox, and re gently completed 5 weeks of radiation/ oral capcitabene with very mild side effects (some nausea). I was advised to moisturize my hands and feet twice daily to prevent the hand/foot side effects. That worked! A pleasant change from iv chemo! All the best to you!

Colleen Young, Connect Director | @colleenyoung | Mar 30 11:37am

Hi @ncteacher, I modified the title of your discussion to bring in more members in addition to @krfinlayson who have experience with radiation coupled with capecitabine (Xeloda). I believe this includes members like @jk77 @stevm @gregcsv @marciak9 who may be able to answer your questions.

You may also be interested in these related discussions:
- Is anyone on Capecitabine for pancreatic cancer?
https://connect.mayoclinic.org/discussion/capcitabine/
- Your experience with IMRT (radiation) + capecitebine (oral chemo)?
https://connect.mayoclinic.org/discussion/your-experience-with-imrt-radiation-capecitebine-oral-chemo/
Ncteacher, have you met with the radiation oncologist in the meantime? What decision was made about the radiation protocol?

marcia | @marciak9 | Mar 30 3:06pm

Hello

I didn’t have as many side effects from the capecitabine and radiation. I only had extreme acid reflux from the radiation. That was after 3 weeks of daily radiation to my pancreas.