Inclusion Criteria:

- Provide written informed consent prior to study-specific screening procedures, with
the understanding that the patient has the right to withdraw from the study at any
time, without prejudice.

- Age >18 years

- Ambulatory outpatients (if applicable), with Karnofsky performance status of >60

- Histologically or cytologically confirmed locally advanced nonmetastatic T3-4 N0-3 M0
carcinomas of the rectosigmoid.

- Surgical exploration without resection is permissible.

- Protocol Specific Laboratory Values as defined in section 4.2

- Has a negative serum pregnancy test within 7 days prior to start of therapy (female
patients of childbearing potential).

- Have concomitant medications been reviewed with patient to address contraindicated
medications described in section 7.8 and have precautions been taken as recommended
for each drug? Includes Allopurinol, Cimetidine, Sorivudine and Brivudine,
Anticoagulants, Phenytoin, and Laxatives.

Exclusion Criteria:

Patients who fulfill any of the following criteria will be excluded:

- Pregnant or lactating woman. Woman of childbearing potential with either a positive
or no pregnancy test at baseline. Woman or men of childbearing potential not using a
reliable and appropriate contraceptive method. (Postmenopausal woman must have been
amenorrheic for at least 12 months to be considered of non-childbearing potential).
Patients will agree to continue contraception for 30 days from the date of the last
study drug administration

- Life expectancy < 3 months.

- Serious, uncontrolled, concurrent infection(s).

- Prior unanticipated severe reaction to fluoropyrimidine therapy, or known sensitivity
to 5-fluorouracil, or known DPD deficiency.

- Completion of previous chemotherapy regimen < four weeks prior to the start of study
treatment, or with related toxicities unresolved prior to the start of study
treatment.

- Treatment for other carcinomas within the last five years, except cured non-melanoma
skin and treated in-situ cervical cancer.

- Participation in any investigational drug study within 4 weeks preceding the start of
study treatment.

- Clinically unstable cardiac disease (e.g. congestive heart failure, symptomatic
coronary artery disease and cardiac arrhythmias not well controlled with medication)
or myocardial infarction within the last 12 months.

- Evidence of metastases or history of uncontrolled seizures, central nervous system
disorders or psychiatric disability judged by the investigator to be clinically
significant, precluding informed consent, or interfering with compliance of oral drug
intake.

- Other serious uncontrolled medical conditions that the investigator feels might
compromise study participation.

- Major surgery within 4 weeks of the start of study treatment, without complete
recovery (e.g., delayed wound healing).

- Lack of physical integrity of the upper gastrointestinal tract or malabsorption
syndrome.

- Known, existing uncontrolled coagulopathy

- Any of the following laboratory values:

- Abnormal hematologic values (neutrophils < 1.5 x 109/L, platelet count < 100 x
109/L)

- Impaired renal function (estimated creatinine clearance <30ml/min as calculated
with Cockroft-Gault equation.

- Note: In patients with moderate renal impairment (estimated creatinine clearance
30-50 mL/min) at baseline, a dose reduction to 75% of the capecitabine starting dose
is recommended.

- Serum bilirubin > 1.5 x upper normal limit.

- ALT (SGOT), AST (SGPT) > 2.5 x upper normal limit (or > 5 x upper normal limit
in the case of liver metastases).

- Alkaline phosphatase > 2.5 x upper normal limit (or > 5 x upper normal limit in
the case of liver metastases or > 10 x upper normal limit in the case of bone
disease)

- Unwillingness to give written informed consent or HIPAA privacy authorization.

- Unwillingness to participate or inability to comply with the protocol requirements
for the duration of the study.

- Patient taking a contraindicated medication(s) described in section 6.2.8 (see
inclusion criteria #8 for list of agents) and no appropriate substitute agent is
available, or patient unable or refuses to take substitute agent.