AIM:To evaluate results of pre-operative radiochemotherapyfollowed by surgery for 25 patients with locally advancedun-resectable rectal cancer.METHODS:15 patients with advanced non-resectable rectalcancer were treated with pre-operative irriadiation of 40-46 Gy plus concomitant chemotherapy(5-FU+LV and 5’-DFuR)(RCS group).For comparison,27 similar patients,treated by preoperative radiotherapy(40-50 Gy)plus surgerywere served as control(RS group).RESULTS:No radiochemotherapy or radiotherapy wasinterrupted and then was delayed because of toxicities inboth groups.The radical resectability rate was 73.3%inthe RCS group and 37.0 %(P=0.024)in RS group.Sphincterpreservation rates were 26.6%and 3.7%respectively(P=0.028).Sphincter preservation rates of lower rectal cancerwere 27.3%and 0.0%respectively(P=0.014).Responserates of RCS and RS groups were 46.7%and 18.5 %(P=0.053).The tumor downstage rates were 8(53.3 %)and 9(33.3 %)in these groups(P=0.206).The 3-year overallsurvival rates were 66.7%and 55.6 %(P=0.485),and thedisease free survival rates were 40.1%and 33.2 %(P=0.663).The 3-year local recurrent rates were 26.7 %and 48.1%(P=0.174).No obvious late effects were foundin either groups.CONCLUSION:High resectability is possible following pre-operative radiochemotherapy and can have more sphincterspreserved.It is important to improve the quality of thepatients’life even without increasing the survival or localcontrol rates.Preoperative radiotherapy with concomitantfull course chemotherapy(5-Fu+LV and 5’-DFuR)is effectiveand safe. AIM: To evaluate the results of pre-operative radiochemotherapy followed by surgery for 25 patients with locally advanced un-resectable rectal cancer. METHODS: 15 patients with advanced non-resectable rectalcancer were treated with pre-operative irriadiation of 40-46 Gy plus concomitant chemotherapy (5 For comparison, 27 similar patients, treated by preoperative radiotherapy (40-50 Gy) plus surgerywere served as control (RS group) .RESULTS: No radiochemotherapy or radiotherapy was interrupted then was delayed because of toxicities inboth groups. The radical resectability rate was 73.3% inthe RCS group and 37.0% (P = 0.024) in RS group.Sphincter Preservation rates were 26.6% and 3.7% respectively (P = 0.028) .Sphincter preservation rates of lower rectal cancerwere 27.3% and 0.0% respectively respectively (P = 0.014) .Responserates of RCS and RS groups were 46.7% and 18.5% (P = 0.053). The tumor downstage rates were 8 (53.3%) and 9 these groups (P = 0.206) .The 3-year overallsurvival rates were 66.7% a nd 55.6% (P = 0.485). The 3-year local recurrent rates were 26.7% and 48.1% (P = 0.174) foundin either groups. CONCLUSION: High resectability is possible following pre-operative radiochemotherapy and can have more sphincterspreserved. It is important to improve the quality of thepatients’life even without increasing the survival or localcontrol rates. preoperative radiotherapy with concomitantfull course chemotherapy (5- Fu + LV and 5’-DFuR) is effective and safe.