Mattavelli Davide, Wichmann Gunnar, Smussi Davide, Paderno Alberto, Plana Maria Serrahima, Mesia Ricard Nin, Compagnoni Micaela, Medda Alessandro, Chiocca Susanna, Calza Stefano, Zhan Yinxiu, Rognoni Carla, Tarricone Rosanna, Stucchi Erika, Lorini Luigi, Gurizzan Cristina, Khelik Ksenia, Hovig Eivind, Dietz Andreas, Piazza Cesare, Bossi Paolo
Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy.
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Front Oncol. 2024 Aug 6;14:1433333. doi: 10.3389/fonc.2024.1433333. eCollection 2024.
In locally advanced (LA) laryngeal/hypopharyngeal squamous cell carcinoma (LHSCC), larynx preservation (LP) strategies aim at the cure of the disease while preserving a functional larynx, thus avoiding total laryngectomy and the associated impact on the quality of life. In the last decades, apart from transoral and open-neck organ preservation approaches, several non-surgical regimens have been investigated: radiotherapy alone, alternate, concurrent or sequential chemoradiation, and bioradiotherapy. Despite major progress, the identification of reliable and effective predictors for treatment response remains a clinical challenge. This review examines the current state of LP in LA-LHSCC and the need for predictive factors, highlighting the importance of the PRESERVE trial in addressing this gap. The PRESERVE trial represents a pivotal initiative aimed at finding the optimal therapy for laryngeal preservation specific to each patient through a retrospective analysis of data from previous LP trials and prospectively validating findings. The goal of the PRESERVE trial is to develop a comprehensive predictive classifier that integrates clinical, molecular, and multi-omics data, thereby enhancing the precision and efficacy of patient selection for LP protocols.
在局部晚期喉/下咽鳞状细胞癌（LHSCC）中，保喉（LP）策略旨在在保留功能性喉部的同时治愈疾病，从而避免全喉切除术及其对生活质量的相关影响。在过去几十年中，除了经口和开放颈部器官保留方法外，还研究了几种非手术方案：单纯放疗、交替、同步或序贯放化疗以及生物放疗。尽管取得了重大进展，但确定可靠且有效的治疗反应预测指标仍然是一项临床挑战。本综述探讨了局部晚期喉/下咽鳞状细胞癌保喉的现状以及对预测因素的需求，强调了PRESERVE试验在填补这一空白方面的重要性。PRESERVE试验是一项关键举措，旨在通过回顾性分析既往保喉试验的数据并前瞻性验证研究结果，为每位患者找到特定的最佳保喉治疗方法。PRESERVE试验的目标是开发一种综合预测分类器，整合临床、分子和多组学数据，从而提高保喉方案患者选择的精准度和疗效。
