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

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.