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
头颈部癌（Head and neck cancer）是涵盖头颈部区域各类肿瘤表现的统称，病变累及口腔、咽部（包括鼻咽、口咽及下咽）、喉与鼻窦。头颈部癌的治疗手段包括手术、放射治疗、化学治疗与免疫治疗（手术、放疗、化疗及免疫治疗），具体治疗方案需结合患者肿瘤的部位、分期以及整体健康状况个体化制定。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（head and neck squamous cell cancer, HNSCC）的高效治疗选择。但该治疗方案也可能诱发脊椎椎间盘炎（spondylodiscitis）。脊椎椎间盘炎指始于椎体终板并累及椎间盘的感染性病变，通常好发于成人群体。

病例报告与结论
本病例报告梳理了本临床团队收治的3例头颈部肿瘤患者接受根治性放化疗后并发脊椎椎间盘炎的诊疗经验：上述3例病例近期于本门诊就诊并接受诊断与治疗，本研究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。