II期和III期直肠癌怎么治疗，手术切除后是不是必要化疗？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">小团：中期直肠癌该怎么治疗？<span style="color: black;">倘若</span>进行了手术切除还要进行化疗吗？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">小圆：II期、III期的直肠癌手术切除后<span style="color: black;">通常</span>还<span style="color: black;">必须</span>化疗，<span style="color: black;">由于</span>手术可能很难将肿瘤细胞切除干净，手术后化疗<span style="color: black;">一般</span>是为了将残余癌细胞杀死，以降低癌症复发的<span style="color: black;">危害</span>。<span style="color: black;">能够</span><span style="color: black;">瞧瞧</span>下面的科普文，<span style="color: black;">认识</span><span style="color: black;">更加多</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">按照</span>肿瘤的扩散程度，以及环周切缘<span style="color: black;">是不是</span>清晰，或<span style="color: black;">周边</span>组织是否受累，治疗II期和III期直肠癌的<span style="color: black;">办法</span>分为两组。环周切缘是衡量直肠癌侵入<span style="color: black;">周边</span>组织的程度。<span style="color: black;">通常</span><span style="color: black;">经过</span>骨盆MRI对直肠癌的环周切缘进行<span style="color: black;">评定</span>。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-d0e6b27c9abd1099bfb50e9d43d7c7e3_720w.webp" style="width: 50%; margin-bottom: 20px;"></div><span style="color: black;">照片</span><span style="color: black;">源自</span>于网络<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">阳性或浸润性的环周切缘<span style="color: black;">寓意</span>着肿瘤<span style="color: black;">已然</span>深入到<span style="color: black;">周边</span>的组织，手术可能很难将肿瘤细胞切除干净。<span style="color: black;">因此呢</span>，<span style="color: black;">一般</span>术后<span style="color: black;">必须</span>进行<span style="color: black;">更加多</span>的治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>是清晰的环周切缘<span style="color: black;">寓意</span>着肿瘤<span style="color: black;">无</span>浸润到<span style="color: black;">周边</span>组织，残余肿瘤的<span style="color: black;">危害</span>较低。<span style="color: black;">因此呢</span>，术后治疗可能比较少。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">较低程度的浸润性直肠癌</h2>肿瘤已扩散到直肠壁的第二层(T1)或第三层(T2)，<span style="color: black;">况且</span><span style="color: black;">周边</span>淋巴结有癌细胞(III期)。 <span style="color: black;">没</span>论淋巴结<span style="color: black;">是不是</span>有癌细胞，肿瘤已突破直肠壁的第三层，并扩散到结肠和直肠<span style="color: black;">周边</span>的组织(T3)，<span style="color: black;">况且</span>其环周边缘清晰。<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-8fd2bc0402fe2983d9eab6d5b22d09fc_720w.webp" style="width: 50%; margin-bottom: 20px;"></div><span style="color: black;">照片</span><span style="color: black;">源自</span>于网络<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">符合<span style="color: black;">以上</span>任何一种<span style="color: black;">状况</span>，<span style="color: black;">重点</span>有三种治疗<span style="color: black;">方法</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗<span style="color: black;">方法</span>1</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">可化疗和<span style="color: black;">长时间</span>放疗相结合治疗。首选化疗<span style="color: black;">方法</span>是卡培他滨和5-FU输注化疗，<span style="color: black;">或</span>大剂量5-FU/亚叶酸钙。治疗结束后，<span style="color: black;">大夫</span>可能会做影像学<span style="color: black;">检测</span>，<span style="color: black;">瞧瞧</span>癌症分期<span style="color: black;">是不是</span><span style="color: black;">已然</span>改变。<span style="color: black;">倘若</span>化疗和<span style="color: black;">长时间</span>放疗的效果很好，<span style="color: black;">能够</span><span style="color: black;">思虑</span>手术(经腹切除术)治疗。手术后，继续化疗来杀死剩余的癌细胞。化疗<span style="color: black;">药品</span>的<span style="color: black;">选取</span>将取决于肿瘤的原始<span style="color: black;">体积</span>(在化疗和放疗之前)以及淋巴结<span style="color: black;">是不是</span>有癌细胞。<span style="color: black;">倘若</span><span style="color: black;">不可</span>手术治疗，可<span style="color: black;">思虑</span>全身治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗<span style="color: black;">方法</span>2</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">可短期放疗。<span style="color: black;">倘若</span>短期放疗的效果好，<span style="color: black;">能够</span><span style="color: black;">思虑</span>手术(经腹切除术)治疗。手术后，继续化疗来杀死剩余的癌细胞。化疗<span style="color: black;">药品</span>的<span style="color: black;">选取</span>将取决于肿瘤的原始<span style="color: black;">体积</span>(在化疗和放疗之前)以及淋巴结<span style="color: black;">是不是</span>有癌细胞。<span style="color: black;">倘若</span><span style="color: black;">不可</span>手术治疗，可<span style="color: black;">思虑</span>全身治疗。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic2.zhimg.com/80/v2-46fada5806542408d8e272a246eed7cd_720w.webp" style="width: 50%; margin-bottom: 20px;"></div><span style="color: black;">照片</span><span style="color: black;">源自</span>于网络<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗<span style="color: black;">方法</span>3</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">可化疗。FOLFOX和CAPEOX是首选<span style="color: black;">方法</span>，FU/LV和卡培他滨<span style="color: black;">亦</span>是首选<span style="color: black;">方法</span>。化疗后，有两种治疗<span style="color: black;">方法</span>。一是放化疗(化疗和放疗)。另一种是短期放疗。治疗结束后，<span style="color: black;">大夫</span>可能会做影像学<span style="color: black;">检测</span>，<span style="color: black;">瞧瞧</span>癌症分期<span style="color: black;">是不是</span><span style="color: black;">已然</span>改变。<span style="color: black;">倘若</span>治疗效果足够好，<span style="color: black;">能够</span><span style="color: black;">选取</span>手术。手术后，<span style="color: black;">没</span>需进一步治疗。您<span style="color: black;">能够</span><span style="color: black;">起始</span>监测癌症的复发。<span style="color: black;">倘若</span><span style="color: black;">不可</span>手术治疗，可<span style="color: black;">思虑</span>全身治疗。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">更高程度的侵袭性直肠癌</h2><span style="color: black;">没</span>论淋巴结<span style="color: black;">是不是</span>有癌细胞，肿瘤已突破直肠壁的第三层，并扩散结肠和直肠<span style="color: black;">周边</span>的组织(T3)，并累及环周切缘。癌症已突破直肠壁，并扩散到<span style="color: black;">周边</span>的器官或组织（T4)。癌症<span style="color: black;">不可</span><span style="color: black;">经过</span>手术切除。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">符合<span style="color: black;">以上</span>任何一种<span style="color: black;">状况</span>，<span style="color: black;">重点</span>有三种治疗途径。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic2.zhimg.com/80/v2-ed442410acfb8d42ae60b4569de10b51_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>网络<span style="color: black;">源自</span>于网络<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">从化疗和长程放疗<span style="color: black;">起始</span>。在完成放疗的6周后做影像学<span style="color: black;">检测</span>，<span style="color: black;">瞧瞧</span>癌症分期<span style="color: black;">是不是</span><span style="color: black;">已然</span>改变，<span style="color: black;">瞧瞧</span>能否手术治疗。<span style="color: black;">倘若</span>环周切缘很清晰，可<span style="color: black;">选取</span>手术。手术后，继续化疗杀死残余的癌细胞。<span style="color: black;">倘若</span>环周切缘很清晰，但<span style="color: black;">由于</span>其他<span style="color: black;">原由</span><span style="color: black;">不可</span>手术治疗，<span style="color: black;">那样</span><span style="color: black;">能够</span>全身治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在完成放疗的6周后做影像学<span style="color: black;">检测</span>，<span style="color: black;">发掘</span>环周切缘不清晰，<span style="color: black;">而后</span>化疗12至16周。首选FOLFOX或CAPEOX<span style="color: black;">方法</span>，<span style="color: black;">或</span>5-FU/亚叶酸钙和卡培他滨。化疗后，再做影像学<span style="color: black;">检测</span>，<span style="color: black;">瞧瞧</span>癌症分期<span style="color: black;">是不是</span>改变。<span style="color: black;">倘若</span><span style="color: black;">能够</span>手术，就做手术，术后继续化疗杀死残余的癌细胞。<span style="color: black;">倘若</span><span style="color: black;">不可</span>手术治疗，<span style="color: black;">那样</span><span style="color: black;">必须</span>全身治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗从12到16周的化疗<span style="color: black;">起始</span>。FOLFOX和CAPEOX是首选化疗<span style="color: black;">方法</span>，<span style="color: black;">亦</span><span style="color: black;">能够</span><span style="color: black;">选取</span>FU/LV和卡培他滨。化疗后，进行放化疗（<span style="color: black;">亦</span><span style="color: black;">便是</span>化疗和放疗）。接下来，<span style="color: black;">大夫</span>会做影像学<span style="color: black;">检测</span>，<span style="color: black;">瞧瞧</span>癌症分期<span style="color: black;">是不是</span><span style="color: black;">已然</span>改变。<span style="color: black;">倘若</span>治疗效果很好，<span style="color: black;">那样</span>，<span style="color: black;">能够</span>进行手术。术后，<span style="color: black;">没</span>需进一步治疗。您<span style="color: black;">能够</span><span style="color: black;">起始</span>监测癌症复发。<span style="color: black;">倘若</span><span style="color: black;">不可</span>手术治疗，<span style="color: black;">那样</span><span style="color: black;">必须</span>全身治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">直肠癌<span style="color: black;">病友</span>群：Drliaowj</p>
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