Background: Radio-immunotherapy is a promising treatment that combines radiotherapy with immunotherapy to enhance the efficacy of cancer treatment. This approach aims to use radiationinduced cell death to release tumor-associated antigens, which then activate the immune system to target and kill cancer cells. Furthermore, radiotherapy can induce the expression of immune checkpoint molecules such as programmed death-ligand 1 (PD-L1), which can be targeted by immune checkpoint inhibitors (ICIs). This study aims to investigate previous studies related to radiotherapy and immunotherapy for enhanced treatment of rectal cancer. Methods: Nine databases (PubMed, Scopus, Google Scholar, Cochrane Library, Magiran, SID, Medline, Embase, and Lilacs) were searched for published articles on radiotherapy and immunotherapy for enhanced treatment of rectal cancer from January 2000 to January 2023. Fifteen articles with complete abstracts were included in this study. All data were extracted from interconnected papers and analyzed with R version 4.2.1 artificial intelligence software. Results: Radiotherapy can help enhance the body\\\\\\\\\\\\\\\'s immune response to cancer cells by increasing the release of tumor antigens, promoting the infiltration of immune cells, and upregulating the expression of immune checkpoint molecules. Furthermore, radiotherapy can also induce DNA damage and increase the production of pro-inflammatory cytokines, which can further enhance the antitumor immune response. These effects can help make the tumor microenvironment more receptive to immunotherapy and increase the likelihood of a successful treatment outcome. The studies suggest that combining radiotherapy and immunotherapy may be promising for treating rectal cancer. Conclusion: In conclusion, Radio-immunotherapy is a promising treatment modality for rectal cancer that has the potential to overcome resistance to immunotherapy alone. Preclinical and clinical studies have demonstrated the potential of this approach, although several challenges need to be addressed to optimize its efficacy.

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