Timing of radiotherapy in head and neck free flap reconstruction – a study of postoperative complications

Sustained Inflammation Due to Nuclear Factor-Kappa B Activation in Irradiated Human Arteries

“…The adverse effects of radiation on tissues can be divided into acute (early), usually occurring within 4 to 6 weeks after irradiation, and late effects, which might be evident months or even years after irradiation, indicating an ongoing proSee page 1237 gressive process (5). The evidence of late adverse effects mainly comes from epidemiological studies (1)(2)(3)(4)(5), whereas previous experimental studies have focused on acute effects, mainly in cell culture experiments (6 -9) and animal models (10 -14). Therefore, it is of particular interest to study long-term biological effects of radiotherapy on the vasculature in humans.…”

“…Radiation therapy has until recently been widely used for prophylaxis against restenosis after coronary angioplasty but limited by late restenosis and vascular occlusion (3). Furthermore, surgical wounds within previously irradiated tissues are subject to vascular alterations associated with increased incidence of post-operative complications, including microvascular occlusion and delayed wound-healing (4). The adverse effects of radiation on tissues can be divided into acute (early), usually occurring within 4 to 6 weeks after irradiation, and late effects, which might be evident months or even years after irradiation, indicating an ongoing proSee page 1237 gressive process (5).…”

Stem Cell Therapy Remediates Reconstruction of the Craniofacial Skeleton After Radiation Therapy

“…The bone subjected to X-ray radiation therapy (XRT) demonstrates increased bone resorption, decreased osteogenesis, and reduced [11,12] mechanical strength [13] that predisposes the patients to the debilitating problem of late pathologic fractures with disastrous functional consequences [14]. Due to these severe problematic wound-healing issues, surgical treatment of HNC poses an ongoing challenge [15,16] and many of these patients eventually become dependent on narcotics to help alleviate their suffering. In extreme cases (like that of Roger Ebert, movie critic), radiation and failed reconstruction can lead to mandibular excision, consigning patients to suffer a life of profound pain and an inability to eat, drink, or speak.…”

Reconstrucción de cabeza y cuello mediante colgajos libres microvascularizados. Indicaciones, aspectos técnicos y resultados

“…No hay evidencia de asociación entre el desarrollo de complicaciones y factores como la histología tumoral, el tipo de colgajo o la RT pre o postoperatoria. Sin embargo, Halle et al 29 sí hallaron un aumento de las complicaciones en los pacientes con RT previa. La presencia de comorbilidad preoperatoria podría aumentar el número de complicaciones, por lo que se debe intentar controlar ciertos factores de riesgo 30 .…”