title: Necrotizing fasciitis as a late complication of multimodal treatment for locally advanced head and neck cancer: a case report.
abstract: BACKGROUND
  Late complications of novel organ preservation multimodal protocols for the treatment of locally advanced head and neck cancer may be underreported in the literature.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil. maluffc@uol.com.br
authors.forename: Fernando C
authors.initials: FC
authors.lastname: Maluf
authors.forename: William N
authors.initials: WN
authors.lastname: William
authors.forename: Otelo
authors.initials: O
authors.lastname: Rigato
authors.forename: Antonio D
authors.initials: AD
authors.lastname: Menon
authors.forename: Orlando
authors.initials: O
authors.lastname: Parise
authors.forename: Marcos F L
authors.initials: MF
authors.lastname: Docema
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000382:microbiology / Q000601:surgery; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012772:Shock, Septic / Q000382:microbiology; D014059:Tongue / Q000382:microbiology / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents