Outcomes of postoperative radiation therapy in fibular free flap reconstruction for head and neck cancer

Abstract

In the treatment of an advanced stage head and neck cancer, additional therapeutic modalities are often combined with surgery. The timing of surgery in relation to other treatment modalities, such as radiation or chemoradiation therapy, remains a topic of continuous discussion. In this study, a series of 13 patients who underwent segmental mandibulectomy followed by postoperative irradiation or chemoradiation at Turku University Hospital between 2011 and 2018 was analyzed. Radiation therapy was scheduled from five to twelve weeks after the surgery. All 13 fibular reconstruction flaps remained viable at the last follow-up. In general, the outcomes of these patients` fibula grafts were consistent with results published by other institutes. It was concluded that postoperative irradiation does not have a negative impact on the survival of microvascular fibular flaps. However, postoperative radiation therapy appeared to increase late complications in the grafts.