ObjectiveTo analyze the clinical predictive factors of tumor pathological response to preoperative chemoradiotherapy for rectal cancer. MethodsOne hundred and seven patients treated with preoperative capecitabine and pelvic conformal radiotherapy and underwent total mesorectal excision from January 2005 to December 2012 in this hospital were analyzed retrospectively.Tumor response according to tumor regression grade was evaluated.The correlation of clinicopathologic factors with tumor response was analyzed by logistic regression analysis. ResultsThe single factor analysis results showed that the age, gender, distance of tumor from anal verge, differentiation degree of tumor, infiltration depth of tumor, and pretreatment CA19-9 level were not correlated with rectal cancer pathological response to preoperative chemoradiotherapy (P > 0.05).The tumor circumferential extent, tumor mobilit, lymph node metastasis, pretreatment carcinoembryonic antigen (CEA) level, and pretreatment hemoglobin level were correlated with it (P < 0.05).The logistic regression analysis results showed that non-fixed tumor (P=0.015), pretreatment CEA level≤5.0μg/L (P=0.012), and pretreatment hemoglobin level > 10 g/L (P=0.007) independently predicted a good pathologic response rate. ConclusionTumor mobility, pretreatment CEA level, and hemoglobin level are important predictors of pathological response to preoperative chemoradiotherapy in rectal cancer.