Organ Preservation Strategy of Total Neoadjuvant Chemoradiotherapy for Low Rectal Carcinoma

This trial is testing whether people with early-stage rectal cancer located close to the anal opening can avoid surgery (and preserve the rectum and bowel function) by using a combination of chemotherapy and radiation before any surgical decision is made. This approach, called total neoadjuvant therapy (TNT), aims to shrink the tumor enough that surgery may not be needed. **You may be eligible if...** - You are 18 or older - You have rectal cancer confirmed by biopsy located within 5 cm of the anal opening - Imaging shows early-stage disease (T1–T3, no lymph node or distant spread) - You strongly want to avoid surgery and preserve bowel function - You have not had any prior treatment for this cancer - You are otherwise suitable for chemoradiotherapy **You may NOT be eligible if...** - You have already received surgery, radiation, or chemotherapy for this cancer - You have other diseases of the colon or rectum - You have a family history of familial polyposis - You have had prior bowel surgery or pelvic radiation - You are pregnant or breastfeeding - Tumors larger than 4 cm, or certain high-risk tumor features, may also disqualify you Talk to your doctor to see if this trial is right for you.