Abstract: In China, most of patients with rectal cancer have been diagnosed in advanced stage, with a higher rate of local recurrence and distant metastasis. Preoperative chemoradiotherapy can improve tumor downstaging, surgical R0 resection rate and local control. However, it has not reduced the rate of distant metastatic relapse. Enhancing preoperative chemotherapy and increasing radiation doses have been reported to further reduce the local recurrence, distant metastasis rate, even to achieve a long-term survival beneft, and becomes the hotspot of research to locally advanced rectal cancer.