Inclusion Criteria:

- Histologically proven adenocarcinoma of the rectum, the lower pole less than 15 cm
from the anal verge

- Patient should not have receive any treatment for cancer

- Synchronous metastases with unresectable hepatic and/or lung localization or
uncertain resectability (potentially resectable)

- Measurable lesions by RECIST 1.1 (metastasis and primary cancer of the rectum)

- Age ≥ 18 years

- WHO ≤ 2

- ANC ≥ 1.5 x 10 9/L, platelets ≥ 100 x 10 9/L, creatinine clearance ≥ 60 mL/min

- Hemoglobin ≥ 10 g /dL

- Signed informed consent

Exclusion Criteria:

- Rectal Cancer in occlusion requiring surgery or a prosthesis in emergency

- Rectal bleeding severe and active

- Prior pelvic irradiation

- History of cancer, except non-melanoma skin cancer, carcinoma in situ of the cervix
treated curatively and other cancers treated curatively if they do not relapse over 3
years,

- Hepatic impairment (total bilirubin> 1.5 x upper limit of normal (ULN) and serum
albumin <25g / L); known Gilbert's disease

- Uncontrolled severe infection,

- Severe pain (VAS> 5/10) uncontrollable by opioid therapy

- Symptomatic sensorimotor peripheral neuropathy

- Pregnant or lactating patients or patient of both sexes with childbearing potential
and not using adequate contraception method

- Patient receiving or having received an experimental therapy within 4 weeks prior to
enter into the study or participating in another clinical study of other experimental
drugs

- Known hypersensitivity to any component of the treatment