What dose-fractionation would you use for cutaneous head and neck squamous cell carcinoma status post resection and skin grafting?

I use the same fractionation schedule that I would use otherwise. Split thickness grafts tolerate radiation poorly, particularly on the scalp. Free flaps are preferred. 60 Gy/30 Fx for negative margins, 66/33 for positive margins, and 70/35 for gross disease.

60 Gy/30 fractions once healing is adequate. I typically do not use hypofractionated radiotherapy in this situation.