Patient: Description of condition (time of onset, main symptoms, hospital visited, etc.): 1. What is meant by time-dependent chemotherapy? Is Siroda (longpeitabine tablets) a time-dependent chemotherapy drug and why? What are the characteristics of time-dependent chemotherapeutic agents? How does it differ from other chemotherapeutic agents? Is it true that because Xyroda is a time-dependent chemotherapeutic agent, when considering adjusting the treatment regimen of Xyroda due to side effects, the main focus should be to ensure the duration of dosing? (That is, the beginning of the set every 14 days to take the Herodal, rest 7 days, if you need to adjust the treatment plan, take the drug or take 14 days, rest 7 days, and reduce the amount of drug, not to ensure the amount of drug, but to ensure that 21 days a cycle of drug) This understanding is correct? 2.What is the current professional “human body surface area calculation table”? Where can I buy it, pick it up (will someone send it to me?) Or can I see it? Could you please tell me what is the body surface area of a patient taking 6 tablets of Siroda a day (1500 mg twice a day)? If I take 5 tablets of Siroda a day (2 times a day, 1000 mg in the morning and 1500 mg in the evening) what should be the body surface area of the patient? Thank you ~ 3, in general, taking the total bilirubin, direct (conjugated) bilirubin, indirect (free) bilirubin, how high the value above the need to extend the rest period (such as taking 14 days of drug rest 7 days, to take 14 days of drug rest 10 days to 14 days) total bilirubin, direct bilirubin, indirect bilirubin in how high the value above the need to reduce the amount of Herodar, how to reduce in general? Why is it possible to return to the original dose if the side effects are controlled with other medications? Only in the case of secondary side effects does Xyroda have a chance to return to the dose set in the treatment plan from the reduced dose. (For example, from taking 7 tablets per day to 6 tablets per day after the total bilirubin is normal, then from 6 tablets per day back to 7 tablets per day) But the second time to reduce the dose, it can not be restored to the dose set by the beginning of the treatment program (that is, the second time due to secondary side effects down to 6 capsules per day, even if the bilirubin is normal, can not be back to 7 capsules per day) This is why? 4.If I can’t continue the treatment due to side effects (not because I can’t continue the treatment due to failure), can I continue the treatment if there is a way to avoid side effects in the future? Will there be resistance to the drug already? And the efficacy of the drug will not be good if I take Xiroda in the future? Or will the efficacy of the drug be continuous in the future even though I stop taking Xiroda now? 5, the instructions of the Xilodar written “Capecitabine can cause hyperbilirubinemia, if the drug-related bilirubin rise > 3.0 * ULN or liver transaminases (ALT, AST) rise > 2.5 * ULN, should immediately suspend the use of Capecitabine, when the bilirubin is reduced to less than or equal to 3.0 * ULN or liver transaminases less than or equal to 2.5 * ULN When the bilirubin decreases to less than or equal to 3.0*ULN or the liver transaminases to less than or equal to 2.5*ULN, capecitabine can be resumed. What does ULN mean and what does it refer to? The reference range for bilirubin is 1.71-17.1 UMOL/L. What is an elevated bilirubin >3.0*ULN and what does it mean? Answer: Hello! Your question is very professional, the answer is as follows: 1, chemotherapy drugs are divided into two categories according to the characteristics of action: dose-dependent and time-dependent, of course, this is only one of many classification methods, generally speaking, for time-dependent chemotherapy drugs, because it only acts on a certain cycle of cells, such as the role of Siroda in the S-phase tumor cells, so should try to extend the drug administration time to ensure a long time higher The tumor cells continue to proliferate and once they enter the S-phase, they become the target of Herodar. At present, the common clinical dosing regimen of Siroda is 14 days of continuous dosing with 7 days of rest. Studies have shown that this dosing regimen is comparable to that of 5-fluorouracil, another similar chemotherapy drug that must be administered intravenously (the latter has been studied for decades and has become one of the standard regimens for many tumors). It has become a standard drug regimen because of its low side effects and ease of administration. In view of this, if the dose is to be adjusted, of course, the dose of each administration should be changed, and the duration of administration should not be modified. The calculation of body surface area is usually done with a ruler, which is based on the patient’s weight and height, or with the formula Body surface area (m2) = 0.0061 x height (cm) + 0.0128 x weight (kg) – 0.1529 The latter question is difficult to answer, because the dose of Siroda is different for different tumors and different regimens. The usual dose is 825mg/m2, 1000mg/m2 or 1250mg/m2 twice a day. Generally, if the total bilirubin exceeds 3 times the upper limit of normal and/or the transaminase exceeds 5 times the upper limit of normal ULN (Upper Limit of Normal: upper limit of normal value), it indicates that the toxic side effects have reached III-IV degree and need to be stopped. If these side effects occur during the course of the drug, the drug should be discontinued (unless the elevated bilirubin and transaminases are due to liver metastases, in which case we do not normally discontinue the drug or change the dose). If it is necessary to use chemotherapy in the future, the dose can be reduced by 25% each time, and in the future, the drug should be used only at this dose and not back to the starting dose level, and if there are still toxic side effects mentioned above, it is better to stop using it. 4. The toxic side effects do not mean that the tumor is resistant to the drug, but it will still be effective after adjusting the dose. However, in actual use, adjusting the dose is a desperate measure, and the lowered dose may mean that the anti-tumor effect is also discounted, so you can take prior measures to strengthen liver protection to avoid greater toxic side effects. 5, ULN has been explained above, due to the different testing laboratories, the reagents used also have some differences, so the normal range of each laboratory may have some differences, 3.0 * ULN is also 3.0 multiplied by the reference range value.