{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:19:08Z","timestamp":1787933948963,"version":"build-2784847793"},"reference-count":34,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO Oncol Adv"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>The ECOG-ACRIN E3311 phase II trial demonstrated outstanding disease control (90.6% 54-month progression-free survival) after transoral surgery (TOS) with de-escalated, risk-based postoperative management in resectable human papillomavirus\u2013associated oropharyngeal cancer. The goal of de-escalation was functional preservation. The objective of this work was to evaluate clinician-graded modified barium swallow (MBS) studies from E3311 over time and across arms for (1) aspiration and high-grade pharyngeal residue rates, (2) differences in swallow safety and efficiency, and (3) accuracy of site clinicians reporting against central MBS review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Eight hundred eighty-five MBS studies were performed on 314 patients from 50 of 59 sites at baseline, post-TOS, and 6 and 24 months postradiotherapy (RT). Swallow outcomes (aspiration, high-grade residue) were recorded by site clinicians. A subset of 414 MBS studies was centrally graded using penetration-aspiration scale scores and the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Aspiration, residue, and dysphagia rates significantly increased from baseline to post-TOS (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01) and then decreased modestly at 6 and 24 months. At 6 months, swallow outcomes favored the 50- versus 60-Gy arm, with significantly lower aspiration and high-grade dysphagia rates, but this difference was not maintained at 24 months. MBS results reported by site clinicians demonstrated substantial agreement with those assessed by the central laboratory (PABAK, 0.75-0.84;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Swallowing worsened after TOS but improved by 6 and 24 months despite adjuvant therapy. De-escalated adjuvant RT at 50 Gy reduced acute aspiration. Site-reported MBS metrics strongly aligned with DIGEST, showing potential as an accessible metric in cooperative group settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/oa-25-00092","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:59:07Z","timestamp":1763413147000},"source":"Crossref","is-referenced-by-count":3,"title":["Functional Impact of Transoral Surgery and Risk-Based Adjuvant Therapy in Human Papillomavirus\u2013Associated Oropharyngeal Cancer: Swallowing Outcomes From ECOG-ACRIN E3311"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-5706","authenticated-orcid":true,"given":"Katherine A.","family":"Hutcheson","sequence":"first","affiliation":[{"name":"The University of Texas, MD Anderson Cancer Center, Houston, TX"},{"name":"The University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-6732","authenticated-orcid":true,"given":"Yael","family":"Flamand","sequence":"additional","affiliation":[{"name":"Dana Farber Cancer Institute-ECOG-ACRIN Biostatistics Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8953-8373","authenticated-orcid":true,"given":"Beatrice","family":"Manduchi","sequence":"additional","affiliation":[{"name":"The University of Texas, MD Anderson Cancer Center, Houston, TX"},{"name":"The University of Texas Health Science Center at Houston, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7605-4329","authenticated-orcid":true,"given":"Harry","family":"Quon","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Weinstein","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2477-9584","authenticated-orcid":true,"given":"Ranee","family":"Mehra","sequence":"additional","affiliation":[{"name":"University of Maryland\/Greenebaum Cancer Center, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquin J.","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-0468","authenticated-orcid":true,"given":"Christine B.","family":"Peterson","sequence":"additional","affiliation":[{"name":"The University of Texas, MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8971-6870","authenticated-orcid":true,"given":"Carly E.A.","family":"Barbon","sequence":"additional","affiliation":[{"name":"The University of Texas, MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan S.","family":"Lewin","sequence":"additional","affiliation":[{"name":"The University of Texas, MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungwon","family":"Kim","sequence":"additional","affiliation":[{"name":"UPMC Hillman Cancer Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enver","family":"Ozer","sequence":"additional","affiliation":[{"name":"Ohio State University, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-0743","authenticated-orcid":true,"given":"Neil D.","family":"Gross","sequence":"additional","affiliation":[{"name":"The University of Texas, MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3775-109X","authenticated-orcid":true,"given":"R. Bryan","family":"Bell","sequence":"additional","affiliation":[{"name":"Providence Cancer Institute, Portland, OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4972-1477","authenticated-orcid":true,"given":"Nabil F.","family":"Saba","sequence":"additional","affiliation":[{"name":"Winship Cancer Institute, Emory University, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne M.","family":"Koch","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Civantos","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Thomas","sequence":"additional","affiliation":[{"name":"Dana-Farber\/Harvard Cancer Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russel B.","family":"Smith","sequence":"additional","affiliation":[{"name":"HCA Florida Memorial Hospital, Jacksonville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9594-1414","authenticated-orcid":true,"given":"Floyd","family":"Holsinger","sequence":"additional","affiliation":[{"name":"Stanford Cancer Institute, Palo Alto, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saral","family":"Mehra","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Gal","sequence":"additional","affiliation":[{"name":"University of Kentucky\/Markey Cancer Center, Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6605-2071","authenticated-orcid":true,"given":"Robert L.","family":"Ferris","sequence":"additional","affiliation":[{"name":"UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4660-1859","authenticated-orcid":true,"given":"Barbara","family":"Burtness","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01752"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.6009"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-015-1598-x"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24344"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-013-9500-y"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/17549507.2019.1596312"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-016-9741-7"},{"key":"e_1_3_8_9_2","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1002\/hed.25542","article-title":"Relationship between oral intake, patient perceived swallowing impairment, and objective videofluoroscopic measures of swallowing in patients with head and neck cancer","volume":"41","author":"Arrese LC","year":"2019","unstructured":"Arrese LC, Schieve HJ, Graham JM, et al: Relationship between oral intake, patient perceived swallowing impairment, and objective videofluoroscopic measures of swallowing in patients with head and neck cancer. 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