Inclusion Criteria:

- Histologically verified rectal carcinoma

- Locally advanced tumor (cT3-4 and/or N+ by transrectal ultrasound and/or pelvic
magnetic resonance imaging)

- the distance from anal verge <= 12cm

- with or without metastasis

- Age 18-75 years old

- ECOG PS 0-2

- No previous chemotherapy or radiotherapy for rectal carcinoma

- Written informed consent

Exclusion Criteria:

- no histologically verified rectal carcinoma

- rectal cancer with stage I

- distance from verge >12cm

- age <=18 or >=75 years old

- performed previously chemotherapy or radiotherapy

- infection diseases within three months

- serious other diseases

- no written informed consent