在局部晚期（LA）喉/下咽鳞状细胞癌（LHSCC）中，保留喉（LP）策略旨在治愈疾病，同时保留功能性喉，从而避免全喉切除术以及对生活质量的相关影响。在过去的几十年中，除了经口和开颈器官保存方法外，还研究了几种非手术治疗方案：单独放疗、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因子仍然是临床挑战。本综述探讨了 LA-LHSCC 中 LP 的现状以及对预测因素的需求，强调了 PRESERVE 试验在解决这一差距方面的重要性。 PRESERVE 试验代表了一项关键举措，旨在通过对先前 LP 试验数据的回顾性分析和前瞻性验证结果，找到针对每位患者的喉保留最佳治疗方法。 PRESERVE 试验的目标是开发一个综合的预测分类器，整合临床、分子和多组学数据，从而提高 LP 方案患者选择的精度和有效性。版权所有 © 2024 Mattavelli, Wichmann, Smussi, Paderno, Plana 、Mesia、Compagnoni、Medda、Chiocca、Calza、Zhan、Rognoni、Tarricone、Stucchi、Lorini、Gurizzan、Khelik、Hovig、Dietz、Piazza 和 Bossi。

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.Copyright © 2024 Mattavelli, Wichmann, Smussi, Paderno, Plana, Mesia, Compagnoni, Medda, Chiocca, Calza, Zhan, Rognoni, Tarricone, Stucchi, Lorini, Gurizzan, Khelik, Hovig, Dietz, Piazza and Bossi.