amifostine + capecitabine

Amifostine + capecitabine is a combination regimen used primarily in the context of radiochemotherapy for rectal adenocarcinoma and other gastrointestinal cancers. Amifostine is a cytoprotective agent that acts as a prodrug, converted in tissues to an active thiol metabolite which scavenges free radicals and protects normal tissues from the toxic effects of chemotherapy and radiation. Capecitabine is an orally administered prodrug of 5-fluorouracil (5-FU), an antimetabolite that inhibits DNA synthesis by interfering with thymidylate synthase, leading to apoptosis in rapidly dividing tumor cells. The combination has been studied as part of hypofractionated accelerated radiotherapy regimens, where amifostine reduces treatment-related toxicity while capecitabine enhances antitumor efficacy through selective activation within tumor tissue[2][3]. This regimen aims to maximize tumor response while minimizing adverse effects on healthy tissue.