UNIVARIATE AND MULTIVARIATE-ANALYSIS OF 8 INDICATIONS FOR POSTOPERATIVE RADIOTHERAPY AND THEIR SIGNIFICANCE FOR LOCAL-REGIONAL CURE IN ADVANCED HEAD AND NECK-CANCER

Eighty consecutive patients with advanced head and neck cancer were tr eated with combined therapy of radical surgery and post-operative radi otherapy. Indications for post-operative radiotherapy were pathologica l staging of the primary tumour (pT3 or pT4), poorly differentiated or undifferentiated carcinoma (G3, G4), tumour thickness, tumour invasio n in the surrounding tissues with slender tumour strands and solitary tumour cells, perineural spread, lymphangio-invasive tumour growth, mu ltiple positive neck nodes or extranodal spread, and microscopical irr adicality of the surgical margins. The contribution for prognosis of t hese indications for post-operative radiotherapy were retrospectively calculated in an univariate and multivariate analysis. Of all investig ated parameters, the mode of tumour invasion and lymphangio-invasive g rowth were independent prognostic factors. If these unfavourable progn ostic signs are present, post-operative radiotherapy has to be intensi fied to at least curative doses of 66 Gy or more to the areas at risk.