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Uni- and multivariate analysis of eight indications for postoperative radiotherapy and their significance for local-regional cure in advanced head and neck cancer

Published online by Cambridge University Press:  29 June 2007

L. A. Ravasz ,
G. J. Hordijk ,
P. J. Slootweg ,
F. Smit  and
I. V. D. Tweel
L. A. Ravasz
Affiliation:
Department of Radiotherapy, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
G. J. Hordijk*
Affiliation:
Department of Ear, Nose and Throat Surgery, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
P. J. Slootweg
Affiliation:
Department of Pathology, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
F. Smit
Affiliation:
Department of Radiotherapy, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
I. V. D. Tweel
Affiliation:
Department of Radiotherapy, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
*
G. J. Hordijk, M.D., Department of Ear, Nose and Throat Surgery, University Hospital Utrecht, Heidelberglaan 100, 3548 CX Utrecht, The Netherlands.
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Abstract

Eighty consecutive patients with advanced head and neck cancer were treated with combined therapy of radical surgery and post-operative radiotherapy. Indications for post-operative radiotherapy were pathological staging of the primary tumour (pT3 or pT4), poorly differentiated or undifferentiated carcinoma (G3, G4), tumour thickness, tumour invasion in the surrounding tissues with slender tumour strands and solitary tumour cells, perineural spread, lymphangio-invasive tumour growth, multiple positive neck nodes or extranodal spread, and microscopical irradicality of the surgical margins. The contribution for prognosis of these indications for post-operative radiotherapy were retrospectively calculated in an univariate and multivariateanalysis. Of all investigated parameters, the mode of tumour invasion and lymphangio-invasive growth were independent prognostic factors. If these unfavourable prognostic signs are present, post-operative radiotherapy has to be intensified to at least curative doses of 66 Gy or more to the areas at risk.

Keywords

Head and neck neoplasmsRadiotherapySurgeryPrognosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 5 , May 1993 , pp. 437 - 440
Copyright
Copyright © JLO (1984) Limited 1993

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