{"entity":{"id":"orator","kind":"trial","name":"ORATOR","aka":[],"tldr":"ORATOR was the first randomised comparison of surgery and radiotherapy for early throat cancer; swallowing scores a year later were slightly better after radiotherapy, but the difference was smaller than patients would notice, so both remain reasonable choices.","summary":"Transoral robotic surgery had spread rapidly for early oropharyngeal cancer on the assumption that it spares swallowing function compared with radiotherapy, without randomised evidence. The Canadian ORATOR trial randomised 68 patients with T1 to T2, N0 to N2 oropharyngeal squamous cell carcinoma, most of them HPV-positive, to radiotherapy (70 Gy, with concurrent cisplatin for node-positive disease) or to transoral robotic surgery with neck dissection and risk-adapted adjuvant therapy. The primary endpoint was the MD Anderson Dysphagia Inventory score at one year.\n\nSwallowing quality of life was statistically better after radiotherapy but the difference fell short of the threshold regarded as clinically meaningful, and the toxicity profiles differed (more bleeding and pain with surgery, more hearing loss and mucositis with radiotherapy). Oncological outcomes were similar and good. The follow-on ORATOR2 trial compared de-intensified versions of both approaches.","status":"mixed","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT01590355","url":"https://clinicaltrials.gov/study/NCT01590355"}],"tags":["subtype-trials"],"related":[],"cancers":["hpv-positive-oropharyngeal-cancer","oropharyngeal-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":["cisplatin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["anthony-nichols"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT01590355","phase":"2","setting":"Early-stage (T1 to T2, N0 to N2) oropharyngeal squamous cell carcinoma: primary radiotherapy (with chemotherapy for node-positive disease) against transoral robotic surgery with neck dissection, with swallowing quality of life at one year as the primary endpoint","sponsor":"London Health Sciences Centre and Lawson Research Institute","result":"Swallowing quality of life at one year was statistically but not clinically meaningfully better after radiotherapy than after transoral robotic surgery; oncological outcomes were similar.","yearReported":2019,"enrolled":68,"outcomes":[]},"route":"/trials/orator/","neighbours":{"cancer":[{"id":"hpv-positive-oropharyngeal-cancer","kind":"cancer","name":"HPV-positive oropharyngeal cancer","route":"/cancers/hpv-positive-oropharyngeal-cancer/"},{"id":"oropharyngeal-cancer","kind":"cancer","name":"Oropharyngeal cancer (tonsil and base of tongue)","route":"/cancers/oropharyngeal-cancer/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"}],"person":[{"id":"anthony-nichols","kind":"person","name":"Anthony C. Nichols","route":"/people/anthony-nichols/"}]}}