Postoperative radiotherapy delay in head and neck cancer patients undergoing major resection and free flap reconstruction

Delays to postoperative radiotherapy (PORT) are frequent and associated with poorer oncologic outcomes in head and neck cancer (HNC) patients. Free flap patients have been suggested as the most at-risk group. Thus, PORT delivery experienced by HNC patients who required a free flap reconstruction was analysed, identifying reasons for the delays if any.A retrospective analysis of a single tertiary unit's PORT delivery to HNC patients undergoing major resection followed by free flap reconstruction between 2017 and 2020.Eighty-seven patients were identified. Thirty-two patients received PORT within 6 weeks of their surgery date. Reasons for the delays could be categorised into surgery-derived, system-derived and patient-derived reasons. Five patients (5.74%) received PORT6 weeks after their surgery due to surgical complications. No patients experienced surgical complications during their PORT.In our experience, surgical aspects of free flap reconstructions do not appear to overtly delay or interrupt PORT.