This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on ISI (5)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Head & Neck Cancer  • Cancer Reconstruction of Head & Neck  • Neoplasms of Head & Neck  • Radiation Therapy  • Alert me on articles by topic

Seungtaek Choi, MD; David L. Schwartz, MD; D. Greg Farwell, MD; Mary Austin-Seymour, MD; Neal Futran, MD, DMD

Arch Otolaryngol Head Neck Surg. 2004;130:1308-1312.

Objective  To determine whether external beam radiation therapy (XRT), administered either before or after surgery, increases the rate and/or severity of local postoperative complications in patients with head and neck cancer who undergo microvascular free flap reconstruction.

Design  Retrospective cohort study.

Setting  University of Washington Medical Center, Seattle, a tertiary care hospital.

Patients  A total of 100 consecutive patients underwent fibular free flap reconstruction of the mandible. The study cohort was divided according to radiation treatment status: (1) no XRT (28 patients), (2) preoperative XRT (37 patients), and (3) postoperative XRT (35 patients). The median follow-up after surgery was 11 months (range, 1-89 months).

Main Outcome Measures  Rate and severity of local postoperative complications.

Results  Fifty-four patients (54%) had at least 1 postoperative complication. There were no differences among the 3 XRT subgroups in the overall proportion of patients with complications of any severity (15 [54%] of 28 patients in the no XRT group, 24 [65%] of 37 patients in the preoperative XRT group, and 16 [46%] of 35 patients in the postoperative XRT group; P = .26, ² analysis). There were also no differences seen when mild and severe complication rates were specifically examined (P = .58 and P = .10, respectively). No case of complete flap loss was observed. We noted no significant correlations between the rate of postoperative complications and the following covariates: total radiation dose, size of radiation field, disease stage, exposure to chemotherapy, presence of serious medical comorbidities, patient age, or history of tobacco use.

Conclusions  Our experience suggests that XRT can be safely administered before or after surgery to patients undergoing head and neck free flap reconstruction at an experienced surgical referral center. Postoperative complication rates were not significantly affected by administration, timing, dose, or extent of XRT.

Author Affiliations: Departments of Radiation Oncology (Drs Choi, Schwartz, and Austin-Seymour) and Otolaryngology–Head and Neck Surgery (Drs Farwell and Futran), University of Washington, Seattle, and the Department of Radiation Oncology, Veteran Affairs Puget Sound Health Care System, Seattle (Dr Schwartz). Dr Schwartz is now with the Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Evaluation of Hardware-Related Complications in Vascularized Bone Grafts With Locking Mandibular Reconstruction Plate Fixation
Knott et al.
Arch Otolaryngol Head Neck Surg 2007;133:1302-1306.
ABSTRACT | FULL TEXT