The primary objective of this study is to compare the organ preservation potential of two neoadjuvant regimens (an escalated dose chemoradiation regimen or short course radiation followed by consolidation chemotherapy) in patients with LARC. Neoadjuvant chemoradiation followed by radical surgery is the standard practice for locally advanced low rectal cancer. However, surgery often leads to formation of a temporary or permanent stoma and is also associated with short term complications and long term bowel, sexual and urinary dysfunction leading to an impaired quality of life. In a recent trial by the investigators, nearly 15% patients refused surgery after neoadjuvant treatment. Total neoadjuvant therapy is increasingly being used in rectal cancer management and increases the tumor response rates. Patients who have a complete response to neoadjuvant treatment have an excellent long term outcome. Although a complete clinical response is not always concordant with a complete pathological response, there is growing interest in a non-operative management of patients who achieve a complete clinical response. The good oncological outcome of this approach is supported by evidence from meta-analyses and publications from a large international registry. It has also been reported that patients who achieve a complete clinical response express a strong preference to avoid surgery and are willing to trade life expectancy for improvements in quality of life. Current organ preserving studies are focusing on an aggressive neoadjuvant long course chemoradiation regimen with consolidation chemotherapy which has shown good results. Short course radiation followed by consolidation chemotherapy is also recommended in locally advanced rectal cancer but its role in organ preservation has not been studied. Hence we intend to compare the organ preserving potential of these two promising regimens in a prospective clinical trial.