This clinical trial is exploring ways to treat low-risk rectal cancer without removing the rectum. The study involves two approaches: *local excision (LE)*, which is a small surgery to remove the cancer, or *non-operative management (NOM)*, which means careful monitoring without surgery. These methods are tested after patients undergo a special type of radiation therapy called *neoadjuvant intensity modulated radiotherapy*, combined with chemotherapy drugs *capecitabine* and *CapeOX*. **Eligibility**: Participants should be between 18-85 years, have a good *ECOG performance status* (a measure of daily living abilities), and a confirmed diagnosis of rectal cancer. The cancer should not have spread to other parts of the body. **Key Points**: - Participants may undergo radical surgery, LE, or NOM based on treatment response. - The study aims to determine the safety and success of these methods. - There are several inclusion and exclusion criteria, such as no previous pelvic treatments and specific health conditions. If you're considering joining, it's important to discuss with your healthcare provider to understand if the study is suitable for you.