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This multispecialty committee included gastrointestinal radiation and medical oncology, gastroenterology, radiology, and colorectal surgery. As is the standard, the previously described American Radium Society Appropriate Use Criteria methodology for this project was followed rigorously, with the Population, Intervention, Comparator, Outcome, Timing, and Study Design framework and Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses methodology to assess the evidence. RAND\/University of California Los Angeles consensus methodology (modified Delphi) was used to rate the appropriateness of treatment options. Published between January 1, 2013, and July 16, 2025, 116 peer\u2010reviewed trials provided the evidence: 10 were well\u2010designed randomized phase 2\/3 trials, 29 were moderately well designed trials that accounted for most common biases (matched cohort and phase 2), 76 trials had design limitations (retrospective), and one was a meta\u2010analysis. 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Although this review does not suggest a major alteration of current practice, it provides reassuring evidence of the importance of combined\u2010modality therapy.<\/jats:p>","DOI":"10.1002\/cncr.70464","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:58:23Z","timestamp":1780649903000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Executive summary of American Radium Society Appropriate Use Criteria for the treatment of locoregionally recurrent rectal cancer"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4931-3521","authenticated-orcid":false,"given":"Eric D.","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology The James Cancer Hospital and Solove Research Institute The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7590-558X","authenticated-orcid":false,"given":"Krishan R.","family":"Jethwa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic College of Medicine  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Dozois","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery Mayo Clinic College of Medicine  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Mayo Clinic College of Medicine  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Abood","sequence":"additional","affiliation":[{"name":"Department of Surgery Loyola University Stritch School of Medicine  Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5357-1814","authenticated-orcid":false,"given":"Dmitriy","family":"Akselrod","sequence":"additional","affiliation":[{"name":"Division of Radiology University of Vermont Larner College of Medicine  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Attallah","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine MetroHealth and Case Western Reserve University School of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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