Influence of radiation therapy on reconstructive flaps after radical resection of head and neck cancer

This study was undertaken to evaluate the influence of radiotherapy (RT) on reconstructive flaps after radical excision of head and neck cancer. Eighty-eight reconstructive flaps were used in 82 patients who received RT either before (PREOP group, 14 flaps) or after (POSTOP group, 74 flaps) surgery. The success and healing rates of the flaps were evaluated. The success and healing rates were lower in the PREOP group than in the POSTOP group (86% vs 99%, P=0.026 for success; and 64% vs 95%, P=0.003 for healing). The rate of acute radiation reaction in flaps in the POSTOP group was significantly lower than in the surrounding normal tissues (35% vs 84%, P=0.003). Late side effects of RT were rare. Our results suggest good radiation tolerance of reconstructive flaps after radical tumour excision in the head and neck region. Success and healing of the flap are likely to be better if RT is administered after surgery.