<h4>Background</h4>We investigated the feasibility of adding neoadjuvant FOLFOXIRI to chemoradiotherapy (CRT) in Chinese patients with high-risk, locally advanced rectal adenocarcinoma (LARC) and examined the prognostic significance of IGF2 and L1CAM expression.<h4>Methods</h4>Eligible patients had non-metastatic, T3/T4 disease with or without nodal involvement, threatened circumferential resection margin (CRM) and/or sphincter involvement, received 4 cycles of a modified FOLFOXIRI regimen, followed by CRT, surgery, then adjuvant chemotherapy. This evidence concerns the gene L1CAM and rectum adenocarcinoma.