Head and Neck Department, Centre Oscar Lambret, Lille, France.
Curr Opin Oncol. 2012 May;24(3):218-22. doi: 10.1097/CCO.0b013e3283523c95.
Organ preservation, in particular larynx preservation, is a major challenge that has been evaluated during the past 3 decades. This review took in consideration the most recently published articles on this topic.
There are no new data on this topic but mainly confirming data. Most of the reports underscored that there was still a place for upfront surgery (either partial or total laryngectomy). Nonsurgical approaches are radiotherapy alone or chemotherapy-based protocols with either induction or concomitant chemotherapy added to radiotherapy (with conventional or accelerated fractionation). Different authors underscored that daily practice must follow carefully the selection of patients and monitoring of treatment when applying protocols evaluated in randomized clinical trials.
Larynx preservation is an undisputable advance in larynx cancer management. For early diseases, either surgery (open or endoscopic) or irradiation may control the disease and preserve the larynx function. For advanced cases, chemotherapy-based protocols have been validated, but the best protocol is still to be defined. Importantly some cases still require upfront total laryngectomy. A multidisciplinary approach for decision making is mandatory, whatever the stage.
在过去的 30 年中，器官保存，特别是喉保存，一直是一个重大挑战。本综述考虑了该主题最近发表的文章。
该主题没有新的数据，主要是确认数据。大多数报告强调，仍有必要进行 upfront 手术（部分或全喉切除术）。非手术方法是单独放疗或基于化疗的方案，要么在放疗中加入诱导或伴随化疗（常规或加速分割）。不同的作者强调，在应用随机临床试验评估的方案时，日常实践必须仔细选择患者并监测治疗。
喉保存是喉癌治疗的一个无可争议的进展。对于早期疾病，手术（开放性或内镜性）或放疗都可以控制疾病并保留喉功能。对于晚期病例，已经验证了基于化疗的方案，但最好的方案仍有待确定。重要的是，有些病例仍需要 upfront 全喉切除术。无论分期如何，决策都需要多学科方法。
