Operable patient Written informed consent 18 years or above ECOG performance status 0–1 Adenocarcinoma of the rectum cT1-cT3ab <5 cm largest diameter <50% of circumference (assessed by MRI and endoscopy) N0-N1 (≤ 3 nodes <8 mm largest diameter) MX/M0 Tumour accessible to CXB, lower tumour border ≤10 cm from the anal verge No comorbidity preventing treatment Follow-up possible
| Inoperable patient T3cd, T4, T ≥5 cm, >50% of circumference Tumour >10 cm from anal verge N2 status or N1 ≥8 mm diameter Metastatic disease (M1) Previous pelvic irradiation Tumour with extramural vascular invasion Poorly differentiated tumour Simultaneous progressive cancer Tumour invading the external anal sphincter or growth within 1 mm of the levator Tumour within 1 mm from MRF Patient unable to receive CXB or CRT Any concurrent medical illness that would preclude protocol therapy Poor compliance Concurrent enrolment in another clinical trial using an investigational anticancer treatment within 28 days prior to study treatment Total DPD deficiency
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