Development of an Online, Patient-Centred Decision Aid for Patients with Oropharyngeal Cancer in the Transoral Robotic Surgery Era

Background: Radiotherapy (RT) has been the standard treatment for early oropharyngeal cancer, achieving excellent outcomes, but with significant toxicities. Transoral robotic surgery (TORS) has emerged as a promising alternative. A decision aid (DA) can help to establish patient treatment preferences. Methods: A DA was developed and piloted in 40 healthy adult volunteers. Assuming equal oncologic outcomes of the treatments, participants indicated their preference. The treatment trade-off point was then established, and participant perceptions were elicited. Results: More than 80% of participants initially selected TORS for treatment, regardless of facilitator background. For all participants, the treatment trade-off point changed after an average 15% cure benefit. Treatment toxicities, duration, novelty, and perceptions all influenced treatment selection. All subjects valued the DA. Conclusions: A DA developed for early oropharyngeal cancer treatment holds promise in the era of shared decision-making. Assuming equal cure rates, TORS was preferred over RT by healthy volunteers.