Hawkins AT, et al. - The use and outcomes of neoadjuvant radiation therapy in clinical T4 colon cancer were assessed via analyzing adults with clinical evidence of T4 locally advanced colon cancer from the National Cancer Database (2004–2014). Outcomes suggest superior R0 resection rates and improved overall survival in association with the use of neoadjuvant radiation for clinical T4 disease. The treatment seems to be most beneficial for patients with clinical T4b disease. It is recommended that physicians consider neoadjuvant radiation therapy on a case-by-case basis in locally advanced colon cancer.