Total Neoadjuvant Therapy With mFOLFOX and Short-course Radiation in Resectable Rectal Cancer

This study is testing a total neoadjuvant therapy (TNT) approach for rectal cancer — where patients receive both chemotherapy (mFOLFOX) and short-course radiation therapy before surgery, rather than splitting treatment before and after. The goal is to shrink the tumor as much as possible before surgery and potentially improve long-term outcomes. **You may be eligible if...** - You are 18 or older - You have a confirmed diagnosis of rectal adenocarcinoma (cancer confirmed by tissue biopsy) - Your cancer is Stage T3–T4 or involves lymph nodes (N1–N2) but has not spread to distant organs (M0) - Your tumor is in the lower part of the rectum (within 12 cm of the anal opening or below the peritoneal fold) - Your blood counts, liver, and kidney function are in acceptable ranges - Your general health is good enough for treatment (ECOG ≤ 2) **You may NOT be eligible if...** - Your cancer has spread to distant organs (metastatic) - You have had prior radiation to the pelvis - Your blood counts or organ function are significantly impaired - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.