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Randomized Controlled Trial
. 2025 Mar;47(3):906-916.
doi: 10.1002/hed.27986. Epub 2024 Nov 4.

Impact of Transoral Robotic Surgery Versus Radiation on Swallowing Function in Oropharyngeal Cancer Patients: A Sub-Study From a Randomized Trial

Julie A Theurer  1   2   3 , Rosemary Martino  2   4   5   6 , Nedeljko Jovanovic  2 , John R de Almeida  5 , David P Goldstein  5 , Kevin Fung  2 , John Yoo  2 , S Danielle MacNeil  2 , Eric Winquist  7 , J Alex Hammond  8 , Varagur Venkatesan  8 , Nancy Read  8 , Sarah Kuruvilla  7 , Andrew Warner  8 , Philip C Doyle  9 , Ian Ross  10 , Colleen Dreyer  11 , Sarah Hawkins  11 , Kendra Thouless  11 , Courtney McCallum  12 , David A Palma  8 , Anthony C Nichols  2
Affiliations
Randomized Controlled Trial

Impact of Transoral Robotic Surgery Versus Radiation on Swallowing Function in Oropharyngeal Cancer Patients: A Sub-Study From a Randomized Trial

Julie A Theurer et al. Head Neck. 2025 Mar.

Abstract

Background: This ORATOR sub-study evaluated swallowing physiology in patients treated with transoral robotic surgery (TORS) versus radiotherapy (RT) for early-stage oropharynx cancer.

Methods: Swallowing physiology was evaluated using videofluoroscopy and outcomes were compared across treatment arms and correlated with MDADI scores.

Results: Of the 68 patients in the ORATOR trial, 21 participated in this sub-study (30.8%), including 15 RT Arm and six TORS Arm patients. Swallowing profiles were not significantly different between the arms. MBSImP pharyngeal scores for RT Arm versus TORS Arm patients were 4.8 (±2.1) versus 4.3 (±1.5) at baseline, 6.2 (±1.2) versus 9.6 (±4.8) at 6 months and 5.9 (±1.8) versus 8.0 (±4.7) at 12 months. MBSImP pharyngeal scores demonstrated weak associations with several MDADI subscales and PAS scores.

Conclusions: To best describe swallowing outcomes in studies of RT and/or surgery, instrumental swallowing assessments should be strongly considered in addition to quality of life measures.

Keywords: ORATOR; oropharyngeal cancer; radiotherapy; swallowing physiology; transoral robotic surgery.

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Figures

FIGURE 1
FIGURE 1
MBSImP Scores by time point and treatment group. [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
PAS scores by time point and treatment group. [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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