Induction Chemotherapy for Locally Recurrent Rectal Cancer

Inclusion Criteria:

• 18 years or older
• Confirmed locally recurrent rectal cancer after total or partial mesorectal resectionfor rectal or distal sigmoidal cancer either by histopathology ór clinically proven (evidence on imaging in combination with clinical findings, with consensus in MDT)
• Resectable disease determined by magnetic resonance imaging (MRI) or deemed resectableafter neoadjuvant treatment with chemoradiotherapy.
• WHO performance score 0-1
• Written informed consent

Exclusion Criteria:

• Radiological evidence of metastatic disease (e.g. liver, lung) at time ofrandomisation or in the six months prior to randomisation.
• Known homozygous DPD deficiency
• Any chemotherapy in the past 6 months.
• Any contraindication for the planned chemotherapy, as determined by the medicaloncologist.
• Radiotherapy in the past 6 months for primary rectal cancer.
• Any contraindication for the planned chemoradiotherapy, as determined by the medicaloncologist and/or radiation oncologist.
• Any contraindication for surgery, as determined by the surgeon and/oranaesthesiologist.
• Concurrent malignancies that interfere with the planned study treatment or theprognosis of resected LRRC.