Reirradiation in Patients with Locoregional Recurrence or a Second Primary Neoplasm within a Previously Irradiated Area after Salvage Surgery with Reconstruction Using Pedicled Flaps and Flaps with Microsurgical Anastomosis

Zbigniew Szutkowski, Andrzej Kawecki, Stanisław Starościak, Maciej Rysz, Marek Pietras, Andrzej Jarząbski, Dorota Kiprian, Anna Jankowska and Izabela Tyburska

Department of Radiotherapy, Maria Skłodowskia- Curie Memorial Cancer Center in Warsaw, Poland
Department of Head and Neck Cancer, Maria Skłodowskia- Curie Memorial Cancer Center in Warsaw, Poland
Department of Physics, Maria Skłodowskia- Curie Memorial Cancer Center in Warsaw, Poland

^*Correspondance to: Zbigniew Szutkowski 

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Abstract:

A salvage surgery is, if possible, a treatment of choice for recurrences following radiotherapy or second primary neoplasms within a previously irradiated area. A complementary radiotherapy to an area of the post tumor removal site with a necessary margin of healthy tissues after a salvage surgery is possible, although it involves a high risk of early and late toxicity. Nine patients operated using pedicled flaps or with creation of vascular microanastomoses for a recurrence or a second primary neoplasm within a previously irradiated location underwent a reirradiation. A survival of a few years in 6 patients, including a symptom-free survival in 3 patients, was achieved. The treatment toxicity was acceptable, although in one case, a necrosis of the mandible requiring surgical treatment occurred. Centers performing reirradiations must have a team of experts experienced in complex planning of radiotherapy or radiochemotherapy possess modern technical facilities and be able to carry out a complex treatment for complications related to undesirable effects of radiotherapy retreatments.

Keywords:

Head and Neck Cancer; Recurrence and Second Primary; Salvage Surgery; Reirradiation

Cite the Article:

Szutkowski Z, Kawecki A, Staro?ciak S, Rysz M, Pietras M, Jarz?bski A, et al. Reirradiation in Patients with Locoregional Recurrence or a Second Primary Neoplasm within a Previously Irradiated Area after Salvage Surgery with Reconstruction Using Pedicled Flaps and Flaps with Microsurgical Anastomosis. Clin Oncol. 2018; 3: 1518.