Supplementary Material for: Patients with spondylodiscitis following chemoradiotherapy for head and neck cancer in a Portuguese cancer hospital - case report

Introduction Head and neck cancer is an umbrella term for tumor manifestations across the head and neck regions, including oral cavity, pharynx (including naso, oro and hypopharynx), larynx, and sinuses. Treatment options for head and neck cancer include surgery, radiation therapy, chemotherapy and immunotherapy (surgery, radiation, chemo and immunotherapy), with specific treatment plans depending upon individual tumor location and staging, together with overall patient health status. Furthermore, definitive chemoradiotherapy (dCRT) has emerged as a highly effective therapeutic option for locoregional advanced head and neck squamous cell cancer (HNSCC). However, such a therapy has also been linked to the development of spondylodiscitis. Spondylodiscitis consists of an infection starting at the vertebral endplates spreading into the intervertebral discs, typically manifesting in adults. Case presentation and conclusion This case report describes our clinical team’s experience in managing three separate cases of spondylodiscitis following dCRT for head and neck tumors, that recently presented at our clinic for diagnosis and treatment, in order to identify predisposing factors that underlie the link between dCRT and spondylodiscitis.

引言 头颈部肿瘤（Head and neck cancer）是涵盖头颈部区域各类肿瘤表现的统称，涉及口腔、咽（包括鼻咽、口咽及下咽）、喉与鼻窦。头颈部肿瘤的治疗手段包括手术、放射治疗、化学治疗及免疫治疗（手术、放疗、化疗及免疫治疗），具体治疗方案需结合患者个体肿瘤的位置、分期以及整体健康状况制定。此外，根治性放化疗（definitive chemoradiotherapy, dCRT）已成为局部区域晚期头颈部鳞状细胞癌（locoregional advanced head and neck squamous cell cancer, HNSCC）的高效治疗方案，但该疗法亦被证实与脊椎椎间盘炎（spondylodiscitis）的发生存在关联。脊椎椎间盘炎指始于椎体终板并向椎间盘扩散的感染性病变，通常累及成人群体。
病例报告与结论 本病例报告阐述了本临床团队处理3例头颈部肿瘤根治性放化疗后并发脊椎椎间盘炎的临床经验，该3例患者近期于本诊所就诊并接受诊断与治疗，旨在明确根治性放化疗与脊椎椎间盘炎之间关联的潜在易感因素。