Resource-Sparing Curative Treatment for Rectal Cancer

Exclusion Criteria

• •Recurrent rectal cancer
• •Primary wholly in the sigmoid colon
• •Considered to be arising in the anal canal
• •Metastatic disease beyond the pelvis (by clinical assessment and/or diagnostic imaging)
• •Contraindications to protocol RT or to protocol chemotherapy, such as one or more of the following:
• •any prior RT to the pelvis; a solitary pelvic kidney within the intended radiation volume
• •consideration by the most responsible radiation oncologist that the treatment volume is too large, or the amount of small bowel or other critical organs within the treatment volume is too much for safe treatment
• •significantly abnormal laboratory tests such as impaired renal/liver function
• •a haemoglobin that is \< 8.0 (or 80, SI) and the patient is not transfused to exceed 8.0 (or 80, SI)
• •on-going medications that are not compatible with protocol neo-adjuvant chemotherapy as described in this protocol
• •Significant development issues (such as with age \< 18 yr)
• •Co-morbidity
• •Psychiatric diagnosis
• •Physical impairment
• •Pregnancy or continuing breast-feeding, that precludes administration of protocol treatments, or that precludes data collection (such as likely to preclude follow-up visits or completing questionnaires)