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Colorectal cancer ranks third amongst various malignancies worldwide out of which a major proportion is of rectal carcinoma. With increasing incidence of rectal cancer amongst younger population in past two decades various advancements towards organ preservation approach have been devised. Total Neo-adjuvant approach (TNT) is current standard of care in various clinical scenarios involving rectal malignancy. In this review article role of Radiation in neo adjuvant setting and various landmark trials leading to it are discussed in detail.

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