In radiotherapy, the tolerable dose of radiation for normal tissues is defined, and irradiating beyond this limit can cause serious complications such as tissue necrosis and ulceration. Herein, we report a case of left oropharyngeal cancer treated with a total of 120 Gy of radiotherapy. In the post-irradiation course, osteomyelitis of the mandible, mucosal necrosis of the oropharynx, and osteomyelitis of the cervical vertebrae occurred at different times, and reconstructive surgery was performed for each. Although reconstructive surgery has been reported for tissue damage caused by conventional radiation therapy, few studies have reported reconstruction for adverse events caused by radiation exposure far in excess of tolerable doses. Re-irradiation is a curative treatment for recurrent head and neck cancer, although the potential for prolonged survival comes with an increased risk of serious adverse events. Although reconstructive surgery for adverse events after re-irradiation is extremely challenging, it should be administered at the appropriate time to help patients maintain their activities of daily living.
