Intervention: Capecitabine
Trial phase: Phase 2
ATC code: L01BC06
SMILES: CCCCCOC(=O)Nc1nc(=O)n([C@@H]2O[C@H](C)[C@@H](O)[C@H]2O)cc1F
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 15
Group description: Patients undergo radiation therapy 5 days a week for a total of 28 fractions. Patients also receive capecitabine PO BID on the days of radiation therapy and curcumin PO BID in weeks 1-11.5.
Eligibility criteria:
Inclusion Criteria:

All patients must have clinical stage T3,4 N0,1,2 or T2N1,2 adenocarcinoma of the rectum; patients will be clinically staged using endorectal ultrasound, pelvic computed tomography (CT) or magnetic resonance imaging (MRI), and physical examination
Histology must be confirmed with review by the Department of Pathology at MD Anderson Cancer Center (MDACC)
All patients must have no distant metastatic disease in the liver, peritoneum, lungs, or paraaortic lymph nodes
Patients must have a performance status (Karnofsky scale) of 70% or greater
Absolute neutrophil count (ANC) > 1200 cells/mm^3
Platelets > 100,000/mm^3
Total serum bilirubin < 2 mg/dl
Blood urea nitrogen (BUN) < 30 mg/dl
Creatinine < 1.5 mg/dl or creatinine clearance > 50cc/min (estimated as calculated with Cockcroft-Gault equation)
Patients must have signed informed consent indicating that they are aware of the investigational nature of the study, and are aware that participation is voluntary; patients must also agree to refrain from use of additional herbal supplements during the course of the study
Patients will agree to continue contraception for 30 days from the date of the last study drug administration; sexually active males must practice contraception during the study
Postmenopausal woman must have been amenorrheic for at least 12 months to be considered of non-childbearing potential

Exclusion Criteria:

Prior complete course up to 5 Gy of radiotherapy to the pelvis
Pregnant or lactating woman; women of childbearing potential who have not undergone a hysterectomy with either a positive or no pregnancy test at baseline; women / men of childbearing potential not using a reliable and appropriate contraceptive method (oral, injectable, or implantable hormonal contraceptive; tubal ligation; intra-uterine device; barrier contraceptive with spermicide; or vasectomized partner)
Treatment for other carcinomas within the last five years, except cured non-melanoma skin and treated in-situ cervical cancer
Patients with uncontrolled intercurrent illness including, but not limited to, ongoing or requiring IV antibiotics, cardiac disease New York Heart Association (NYHA) class III or IV, unstable angina pectoris, unstable cardiac arrhythmia or tachycardia (heart rate > 100 beats/minute), or psychiatric illness/ social situations that would limit compliance with the study requirements are excluded
Other serious uncontrolled medical conditions that the investigator feels might compromise study participation
Major surgery within 4 weeks of the start of study treatment
Prior unanticipated severe reaction to fluoropyrimidine therapy or known hypersensitivity to 5-fluorouracil or capecitabine or curcumin
Concurrent use of Coumadin other than low dose (1 mg) Coumadin used for line patency; patients on Coumadin must be changed to Lovenox at least 1 week prior to starting capecitabine
Concurrent use of cimetidine, allopurinol, or aluminium hydroxide and magnesium hydroxide-containing antacids such as Maalox
Sorivudine and brivudine use within 4 weeks of the start of study treatment