Induction Chemotherapy for MRF-negative, Moderate-risk, Resectable Middle and Low Rectal Cancer

Inclusion Criteria: * • Age ≥18 years and ≤80 years * ECOG Performance status 0-1 * Histologically confirmed diagnosis of adenocarcinoma of the rectum * The distance from down verge of tumor to anal-rectal junction (ARJ) ≤8cm based on MRI, or ≤12cm based on sigmoidoscopy; * Clinical Stage based on MRI 1. mrMRF(-) 2. T3c/T3d/T4a, anyN, or T3bN+ * No evidence of distant metastases * No prior pelvic radiation therapy * No prior chemotherapy or surgery for rectal cancer * No active infections requiring systemic antibiotic treatment * ANC \> 1.5 cells/mm3, HGB \> 10.0 g/dL, PLT \> 100,000/mm3, total bilirubin ≤ 1.5 x ULN, AST≤ 3 x ULN, ALT ≤ 3 x ULN. * Patients must read, agree to, and sign a statement of Informed Consent prior to participation in this study. Exclusion Criteria: * • Recurrent rectal cancer * Primary unresectable rectal cancer. A tumor is considered unresectable when invading adjacent organs and an en-bloc resection will not achieve negative margins. * The pathological grade was Grade 4, i.e. mucus, signet ring or undifferentiated cancer. * Creatinine level greater than 1.5 times the upper limit of normal. * Patients who have received prior pelvic radiotherapy. * Patients who are unable to undergo an MRI. * Patients with a history of a prior malignancy within the past 5 years, except for adequately treated basal cell or squamous cell skin cancer. * Patients with a history of any arterial thrombotic event within the past 6 months. This includes angina (stable or unstable), MI, TIA, or CVA. * Other Anticancer or Experimental Therapy. * Women who are pregnant or breast-feeding. * Patients with any other concurrent medical or psychiatric condition or disease which would make them inappropriate candidates for entry into this study.