What Researchers Did
Researchers analyzed 74 patients who underwent osseous free flap reconstruction, with 38 receiving postoperative radiation therapy, to determine the rate, risk factors, and treatment of osteoradionecrosis.
What They Found
The overall rate of osteoradionecrosis (ORN) was 34%, with rates increasing significantly with higher radiation doses: 0% for 50-59.9 Gy, 40% for 66 Gy, and 56% for 70-74.4 Gy. Postoperative radiation therapy (PORT) exceeding 60 Gy was the only factor predicting ORN, increasing the risk 21-fold, and treatment involved PENTACLO, hyperbaric oxygen, and surgical debridement for 75% of cases within two years.
What This Means for Canadian Patients
Canadian patients undergoing osseous free flap reconstruction who receive postoperative radiation therapy (PORT) should be aware that doses above 60 Gy significantly increase their risk of osteoradionecrosis. Clinicians may consider strategies like lowering PORT doses or delaying free flap reconstruction when appropriate to mitigate this risk for patients.
Canadian Relevance
This study is relevant to Canadian patients as osteoradionecrosis is a known complication of radiation therapy following head and neck cancer surgery, a common treatment in Canada.
Study Limitations
The study's findings are based on a relatively small cohort of 74 patients, which may limit the generalizability of the results.