Objective — to analyze the efficiency of two preoperative radiotherapy regimens for patients with locally advanced rectal cancer from toxicity level, tumor pathomorphism, and local tumor recurrence and survival rates. Subjects and methods. The investigation enrolled 124 patients treated for clinical stage cT3/T4 and N–/N+ rectal cancer at the Clinic of the Medical Radiology Research Center in 2003 to 2013. Of them 64 patients received chemoradiotherapy with continuous infusion of 5-fluorouracil (5-FU) and leucovorin (5-FU as a continuous 120-hour intravenous infusion at a dose of 500 mg/m2 and leucovorin as a 20 mg/m2 bolus) and 60 patients had radiotherapy in combination with capecitabine (825 mg/m2 twice daily). Results. In the 5-FU and capecitabine groups, the total toxicity profile was noted in 50 (81.2%) and 20 (33%) patients, respectively. Complete clinical tumor regression was detected in 5 (8%) patients in the 5-FU group and in 13 (21%) patients in the capecitabine group; partial tumor regression was recorded in 27 (42%) and 38 (63%) patients, respectively. Overall 5-year relapse-free survival rates were 57.2±7.3% in the 5-FU group and 62.4±9.0% in the capecitabine group. Estimation of 5-year survival rates in patients who had undergone R0-R1 resections for Stages I-III rectal cancer showed these to be 60.5±7.5% and 86.6±5.8%, respectively (p>0.05).