Combination of Oxaliplatin, Capecitabine, and Celecoxib With Concurrent Radiation for Rectal Cancer

Inclusion Criteria: All patients 18 years of age or older, with biopsy proven T3-4N0-2M0 rectal cancer are eligible. Life expectancy of at least 2 years. Zubrod performance status of 0-2. Patients must be able to sign an informed consent. Adequate bone marrow function: peripheral granulocyte count of > 1,500 cells/mm3 and platelet count >100,000/mm3, hemoglobin > 10 gm/dl and absence of a regular red blood cell transfusion requirement. Adequate hepatic function with a total serum bilirubin < 1.5 x ULN; alkaline phosphatase, alanine aminotransferase (ALAT), and aspartate aminotransferase (ASAT) < 2.5 x the upper limit of normal (ULN); and adequate renal function as defined by a calculated creatinine clearance > 50 ml/min [Cockroft-Gault]. Other initial cancer diagnosis more than five years ago without evidence of residual or recurrent disease Prior diagnosis of squamous or basal cell carcinoma of skin,no active disease at the time of enrollment. Exclusion Criteria: Known metastases Pregnant or lactating women. Women/men of childbearing potential not using a reliable and appropriate contraceptive method. May receive no other concurrent chemotherapy or radiation therapy during this trial. Severe medical problems such as uncontrolled diabetes mellitus or cardiovascular disease or active infections Prior pelvic radiation Known active inflammatory bowel disease, Crohn's disease or ulcerative colitis. Medical conditions that would preclude the patient from definitive surgery at the end of concurrent chemoradiation Serious, uncontrolled, concurrent infection(s). Prior severe reaction to fluoropyrimidine therapy, or known hyper-sensitivity to 5-fluorouracil or known dihydropyrimidine dehydrogenase (DPD) deficiency. Treatment for other carcinomas within the last five years, except cured non-melanoma skin and treated in-situ cervical cancer. Participation in any investigational drug study within 4 weeks preceding the start of study treatment. Clinically significant cardiac disease or myocardial infarction within the last 12 months. History of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant, precluding informed consent, or interfering with compliance of oral drug intake. Other serious uncontrolled medical conditions that the investigator feels might compromise study participation. Major surgery <4 weeks of the start of study treatment, without complete recovery. Lack of physical integrity of the upper gastrointestinal tract or malabsorption syndrome. Known, existing uncontrolled coagulopathy Any of the following laboratory values: Abnormal hematologic values (neutrophils < 1.5 x 10^9/L, platelet count < 100 x 10^9/L, hemoglobin < 10 gm/dl) Impaired renal function (estimated creatinine clearance <50 ml/min as calculated with Cockroft-Gault equation. Serum total bilirubin > 1.5 x upper normal limit. ALAT, ASAT > 2.5 x upper normal limit (or > 5 x upper normal limit in the case of liver metastases). Alkaline phosphatase > 2.5 x upper normal limit (or > 5 x upper normal limit in the case of liver metastases or > 10 x upper normal limit in the case of bone disease). Unwillingness to give written informed consent. Unwillingness to participate or inability to comply with the protocol for the duration of the study. History of allergic reactions, hypersensitivity reactions to aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or sulfonamides