IMRT-SIB and Capecitabine in Preoperative Rectal Cancer Treatment

Inclusion Criteria: * Biopsy-proven newly diagnosed primary rectal adenocarcinoma * Locally advanced tumor fulfilling at least one of the following criteria on pelvic MRI: * T ≥ 3 or * N ≥ 1 * Positive mesorectal fascia (MRF), i.e. tumor or lymph node one mm or less from the mesorectal fascia * Tumor located od 0 - 15 cm above anocutaneous junction or below peritoneum * Age 18 years and more * Signed informed consent * WHO Performance Status 0-2 * Patients is considered to be mentally and physically ft for chemotherapy as judged by oncologist * Adequate hematological, hepatic and renal function (WBC ≥ 3.0 x 109/L, neu ≥ 1.5 x 109/L, platelet count ≥ 100 x 109/L, renal clearance ≥ 50 ml/min, bilirubin ≤ 3x normal value, aspartate transaminase/alanine transaminase (AST/ALT) ≤ 2,5x normal value) Exclusion Criteria: * T4 inoperable tumor - extensive growth into cranial part of the sacrum (above S3) or the lumbosacral nerve roots * Metastatic or recurrent rectal cancer * Other co-existing malignancy or malignancy within the past 5 years, with the exception of adequately treated in situ carcinoma of the cervix or basal cell carcinoma of the skin * Chronic bowel inflammatory disease * Pregnant or lactating patient * Significant heart disease (uncontrolled hypertension despite of medication (\> 150/100 mmHg), New York Heart Association (NYHA) class III or IV heart disease,unstable angina or myocardial infarction within the past 1 year prior the study entry, history of significant ventricular arrhythmia requiring treatment) * Inability to consciously sign the consent form due to physical or psychological disabilities