{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:39:02Z","timestamp":1791819542854,"version":"4.3.4"},"reference-count":16,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"34","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>\n                    Radiotherapy (RT) and transoral robotic surgery (TORS) are both curative-intent treatment options for oropharyngeal squamous cell carcinoma (OPSCC). Herein, we report the final outcomes of the ORATOR trial comparing these modalities, 5 years after enrollment completion. We randomly assigned 68 patients with T1-2N0-2 OPSCC to RT (with chemotherapy if node-positive) versus TORS plus neck dissection (\u00b1 adjuvant RT\/chemoradiation). The primary end point was swallowing quality of life (QOL) assessed with the MD Anderson Dysphagia Inventory (MDADI). Secondary end points included overall and progression-free survival (OS, PFS), adverse events (AEs), and other QOL metrics. The primary end point has been previously reported (Nichols 2019). In this report, the median follow-up was 5.1 years (IQR, 5.0-5.3 years). MDADI total scores converged by 5 years and were not significantly different across the follow-up period (\n                    <jats:italic>P<\/jats:italic>\n                    = .11). EORTC QLQ-C30 and H&amp;N35 scores demonstrated differing profiles, including worse dry mouth in the RT arm (\n                    <jats:italic>P<\/jats:italic>\n                    = .032) and worse pain in the TORS arm (\n                    <jats:italic>P<\/jats:italic>\n                    = .002). Grade 2-5 AE rates did not differ between arms (91% [n = 31]\n                    <jats:italic>v<\/jats:italic>\n                    97% [n = 33] respectively,\n                    <jats:italic>P<\/jats:italic>\n                    = .61), with more neutropenia and hearing loss in the RT arm, and more dysphagia and other pain in the TORS arm based on grades 2-5 (all\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .05). There were no differences in OS or PFS. In conclusion, toxicity and QOL profiles differ in some domains between RT and TORS, but oncologic outcomes were excellent in both arms. Choice of treatment should remain a shared decision between the patient and their providers.\n                  <\/jats:p>","DOI":"10.1200\/jco.24.00119","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T16:01:12Z","timestamp":1726848072000},"page":"4023-4028","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":54,"title":["Radiotherapy Versus Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma: Final Results of the ORATOR Randomized Trial"],"prefix":"10.1200","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct01590355","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0760-980X","authenticated-orcid":true,"given":"Anthony C.","family":"Nichols","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9790-680X","authenticated-orcid":true,"given":"Julie","family":"Theurer","sequence":"additional","affiliation":[{"name":"School of Communication Sciences and Disorders, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7201-6181","authenticated-orcid":true,"given":"Eitan","family":"Prisman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Read","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Berthelet","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1546-5033","authenticated-orcid":true,"given":"John R.","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Bayley","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Health Network, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hier","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Sultanem","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Richardson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Mlynarek","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5675-1194","authenticated-orcid":true,"given":"Suren","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1527-5889","authenticated-orcid":true,"given":"Hien","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6666-9055","authenticated-orcid":true,"given":"S. Danielle","family":"MacNeil","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8829-5979","authenticated-orcid":true,"given":"Eric","family":"Winquist","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Alex","family":"Hammond","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varagur","family":"Venkatesan","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Kuruvilla","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Warner","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1924-9431","authenticated-orcid":true,"given":"Stephanie","family":"Johnson-Obaseki","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Odell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Corsten","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head and Neck Surgery, Dalhousie University, Halifax, NS, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Audiology, London Health Sciences Centre, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8816-6053","authenticated-orcid":true,"given":"Bret","family":"Wehrli","sequence":"additional","affiliation":[{"name":"Department of Pathology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9542-0627","authenticated-orcid":true,"given":"David A.","family":"Palma","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.02.025"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01961"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30410-3"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27631"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-13-133"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.8841"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2015.09.007"},{"key":"e_1_3_9_10_2","first-page":"945162","article-title":"The role of transoral robotic surgery in the management of oropharyngeal cancer: A review of the literature","volume":"2012","author":"Dowthwaite SA","year":"2012","unstructured":"Dowthwaite SA, Franklin JH, Palma DA, et al: The role of transoral robotic surgery in the management of oropharyngeal cancer: A review of the literature. ISRN Oncol 2012:945162, 2012","journal-title":"ISRN Oncol"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01752"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32779-X"},{"key":"e_1_3_9_13_2","first-page":"1","article-title":"Assessment of toxic effects and survival in treatment deescalation with radiotherapy vs transoral surgery for HPV-associated oropharyngeal squamous cell carcinoma: The ORATOR2 phase 2 randomized clinical trial","volume":"8","author":"Palma DA","year":"2022","unstructured":"Palma DA, Prisman E, Berthelet E, et al: Assessment of toxic effects and survival in treatment deescalation with radiotherapy vs transoral surgery for HPV-associated oropharyngeal squamous cell carcinoma: The ORATOR2 phase 2 randomized clinical trial. JAMA Oncol 8:1-7, 2022","journal-title":"JAMA Oncol"},{"key":"e_1_3_9_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.03128"},{"key":"e_1_3_9_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-020-6607-z"},{"key":"e_1_3_9_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33995"},{"key":"e_1_3_9_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.2725"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.24.00119","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T17:59:45Z","timestamp":1732557585000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.24.00119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":16,"journal-issue":{"issue":"34","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1200\/JCO.24.00119"],"URL":"https:\/\/doi.org\/10.1200\/jco.24.00119","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"2024-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-20","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}