Inclusion Criteria:

All of the following must apply:

- Pathologically documented and clinically resectable adenocarcinoma of the rectum.

- The patient must be considered by the surgeon to be suitable for a curative
resection.

- The patient must be considered by the radiation oncologist to have no
contraindication to pre-operative radiotherapy.

- Clinical T3 stage tumour on endorectal ultrasound or MRI. When endorectal ultrasound
cannot be performed satisfactorily due to a technical reason, such as stenosis or
proximity of the tumour, and MRI is not available, infiltration of perirectal fat on
CT scan is also acceptable.

- Tumour with lower border within 12 cm from anal verge on rigid sigmoidoscopy.

- ECOG performance status 0, 1 or 2.

- Adequate bone marrow function with neutrophil count at least 1.5 x 109/L and platelet
count at least 100 x 109/L.

- Adequate liver function with bilirubin and alanine aminotransferase (ALT) <= 1.5
times the upper limit of normal.

- Adequate renal function with serum creatinine <= 1.5 times the upper limit of normal.

- Accessibility for treatment and follow-up.

- Written informed consent.

Exclusion Criteria:

- None of the following must apply:

- Evidence of distant metastases.

- Recurrent rectal cancer.

- Unstable cardiac disease or clinically significant active infection.

- Other cancer in the last 5 years except treated non-melanoma skin cancer or carcinoma
in situ of the cervix.

- Pregnant or lactating females or female patients of childbearing potential who have
not been surgically sterilized or are without adequate contraceptive measures.

- Contraindication to insertion of a suitable indwelling venous catheter e.g.
implantable central venous device (infuse-a-port), Hickman catheter or peripherally
inserted central catheter.

- Prior pelvic or abdominal radiotherapy.