Capecitabine ( Xeloda®) is the unique oral prodrug of 5-Fu recommended by global guidelines and especially International Society of Geriatric Oncology (SIOG), and it has been verified by clinical trials that in view of efficacy and safety, capecitabine monochemotherapy was equivalent to i.v. 5-Fu/ leucovorin adjuvant chemotherapy. With efficacy retained, a large group of patients prefer capecitabine due to oral administration which can remarkably enhance flexibility and compliance. These advantages make capecitabine a potential ideal choice for elderly patients. According to the NCCN guideline, the standard dosage of capecitabine was 1250mg/m2 .bid. It was well-established that different characteristics such as ethnicity, age and sex could alter the metabolism and change individual tolerance for drugs; hence, there are still controversies on the optimal dose of capecitabine in different populations. The X-Act trial provided a result that among elderly patients (≥ 70 yr) undergoing standard-dose capecitabine adjuvant chemotherapy(1250mg/m2 .bid), 51% of the patients required dose reduction to complete the whole treatment cycle, implying that the recommended 1250mg/m2 .bid. might be an overdose for elderly patients given the fact that only elderly patients with relatively better health (≤ 75 yr, ECOG≤1) were eventually included in X-ACT trial. Chang and colleagues have verified feasibility of a tailored-dose strategy with a starting dose at 1000 mg/m2 .bid in a single-arm study. The European Society for Medical Oncology (ESMO) has also recommended an option of 80% standard dosage (i.e. 1000 mg/m2 .bid) for elderly II/III CRC patients. However, no prospective trial has been conducted yet to confirm this reduced-dose strategy.