Maluf Fernando C, William William N, Rigato Otelo, Menon Antonio D, Parise Orlando, Docema Marcos F L
Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil.
Head Neck. 2007 Jul;29(7):700-4. doi: 10.1002/hed.20558.
Late complications of novel organ preservation multimodal protocols for the treatment of locally advanced head and neck cancer may be underreported in the literature.
We present the case of a 64-year-old man with T4 N0 M0 squamous cell carcinoma of the oropharynx, who enrolled on an organ-preservation protocol at our institution. He received 2 cycles of neoadjuvant chemotherapy with capecitabine, docetaxel, and carboplatin, followed by 2 more identical cycles given concurrently with radiotherapy. Nine months later, he was admitted to the hospital with Streptococcus pyogenes necrotizing fasciitis of the cervical region, leading to rapidly progressive septic shock.
Severe infectious complications of chemoradiation for locally advanced head and neck cancer may occur months after completion of treatment. The recognition of these late side effects is crucial so as to accurately ascertain the long-term morbidity and benefits of organ-preservation protocols in this setting.
用于治疗局部晚期头颈癌的新型器官保存多模式方案的晚期并发症在文献中可能报道不足。
我们报告一例64岁男性，患有口咽T4 N0 M0鳞状细胞癌，在我们机构参加了器官保存方案。他接受了2个周期的新辅助化疗，使用卡培他滨、多西他赛和卡铂，随后又进行了2个相同周期的化疗并同时进行放疗。9个月后，他因颈部化脓性链球菌坏死性筋膜炎入院，导致迅速进展的感染性休克。
局部晚期头颈癌放化疗的严重感染并发症可能在治疗完成数月后发生。认识到这些晚期副作用对于准确确定这种情况下器官保存方案的长期发病率和益处至关重要。
