Vol 25, No 3 (2020)
Published online: 2020-05-01

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Neck emphysema in a HNSCC cancer patient undergoing concurrent radiotherapy and cetuximab

Valerio Nardone1, Maria Grazia Calvanese1, Ida D’Onofrio1, Mario Di Stasio2, Claudio Vitale3, Antonia Silvestri2, Bruno Daniele2, Pierpaolo Correale4, Paolo Fierro5, Giuseppe Tortoriello5, Alfonso Reginelli3, Salvatore Cappabianca3, Cesare Guida1
DOI: 10.1016/j.rpor.2020.03.025
Rep Pract Oncol Radiother 2020;25(3):396-398.



Lung toxicity in patients undergoing cetuximab and radiotherapy (Cetux-RT) for head and neck squamous cell carcinoma (HNSCC) has been reported in literature and represents a serious side effect of concurrent therapies.


We report a case of a HNSCC patient that developed neck emphysema during the course of Cetux-RT. The patient was an old male (80 years old) in a good performance status, with an oropharyngeal cancer (T4aN3a).


During RT, cone-beam computed tomography (CBCT) showed bilateral neck emphysema that was confirmed at restaging CT. We decided to stop the treatment and to treat the neck emphysema with conservative strategies. After one week CT was repeated and the neck emphysema had improved, so we decided to complete the RT treatment.


Patients undergoing Cetux-RT must be properly selected, whereas IGRT imaging must be viewed carefully in order to permit an early diagnosis and careful management of the patients.

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Reports of Practical Oncology and Radiotherapy