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.