Abstract: Preoperative neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) has become the standard treatment protocol for patients with locally advanced rectal cancer (LARC). nCRT significantly reduces tumor volume and decreases the likelihood of recurrence. Accurate prediction of  treatment efficacy, prognosis, and toxicity in LARC patients undergoing nCRT is crucial for optimizing individualized diagnostic and therapeutic strategies. With the  advancement of radiomics and the rapid development of artificial intelligence technology, both fields have demonstrated substantial potential in medical image analysis. This article reviews the progress and limitations of radiomics and artificial intelligence in LARC patients undergoing nCRT, with the aim of providing a reference for development of individualized diagnostic and treatment strategies and exploring future research endeavors.

Key words: Locally advanced rectal cancer, Neoadjuvant chemoradiotherapy, Radiomics, Artificial intelligence