Adaptive Radiation Boost for Rectal Cancer

Inclusion Criteria

• •1. Subjects must have histologically or cytologically confirmed rectal adenocarcinoma.
• •2. Subjects must have T2-3, N0-1, M0 rectal cancer. Staging will be done by MRI pelvis and CT chest and abdomen with contrast. PET-CT will be an acceptable alternative for the CT chest and abdomen.
• •3. Subjects must be willing to undergo MRI scans.
• •4. Age ≥18 years.
• •5. ECOG performance status 0 or 1.
• •6. Estimated survival of ≥ 12 months.
• •7. Subjects must have normal organ and marrow function as defined below
• •* Absolute neutrophil count \> =1,000/mcL
• •* Platelets \>= 75,000/mcL
• •* Total bilirubin \< 3 mg/dL
• •8. Subjects must be able to tolerate the chemotherapy regimens outlined in the treatment plan (Section 5.0), both before and after ART.
• •* Before ART: Capecitabine at a dose of 825 mg/m²
• •* After ART: FOLFOX combination chemotherapy, or 5-FU, or capecitabine
• •9. Subjects must possess the ability to understand and willingness to sign a written informed consent and HIPAA consent document. Translation services including translation of informed consent documents will be provided, as feasible, to encourage diversity of inclusion of eligible patients.