Findings

What do systematic reviews say?

20 questions · 38 findings · 3 reviews · Oral medicine and oral cancer

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No studies found 2 · 5.3%GRADE not reported 26 · 68.4%Very low 5 · 13.2%Low 0 · 0%Moderate 5 · 13.2%High 0 · 0%

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Locoregional control · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Concomitant (concurrent) chemoradiotherapy led to lower locoregional control, concurrent chemoradiotherapy (platinum +… compared with radiotherapy alone (non-resectable tumours); GRADE not reported.

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
RR 0.75 [0.61, 0.93]
3 studies
GRADE not reported

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Disease-free survival · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Concomitant (concurrent) chemoradiotherapy led to lower disease-free survival, concurrent chemoradiotherapy vs radiotherapy… compared with radiotherapy alone (non-resectable tumours); GRADE not reported.

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 0.74 [0.67, 0.80]
13 studies
GRADE not reported

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Overall survival, adjuvant concomitant chemoradiotherapy vs post-surgery radiotherapy alone · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Concomitant (concurrent) chemoradiotherapy probably leads to lower overall survival, concurrent chemoradiotherapy vs radiotherapy alone… compared with radiotherapy alone (non-resectable tumours) (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 0.74 [0.67, 0.83]
24 studies · 2852 participants
Moderate

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Recurrence · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
Recurrence: outcome not reported in a usable way (Mehanna 2017: nodal recurrence 3 vs 1; distant metastases 21 vs 23).
1 study
GRADE not reported

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Total mortality · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

PET-CT following chemoradiotherapy (neck dissection only if… showed no clear difference in total mortality compared with planned neck dissection before or after chemoradiotherapy (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
3 years
HR 0.92 [0.65, 1.31]
1 study · 564 participants
Moderate

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Locoregional recurrence · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

PET-CT following chemoradiotherapy (neck dissection only if… showed no clear difference in locoregional recurrence compared with planned neck dissection before or after chemoradiotherapy (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
3 years
HR 1.00 [0.94, 1.06]
1 study · 564 participants
Moderate

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Adverse events associated with treatment · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
Adverse events: 22 surgical complications in the PET-CT group vs 83 in the planned-surgery group (Mehanna 2017).
1 study · 564 participants
Very low

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Disease-free survival · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
Disease-free survival: outcome not reported in a usable way (Mehanna 2017: disease-specific and other-cause mortality did not differ, P=0.80 and 0.41).
1 study
GRADE not reported

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx

10 findings from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Mucositis (all grades)
Mucositis all grades: not estimable due to high heterogeneity (P=0.0009; I2=86%) between subgroups (cetuximab; nimotuzumab) and within cetuximab (I2=93%); 1417 participants, 3 studies. Table 3, row 1.6 (Ang 2014;…
3 studies · 1417 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Skin toxicity/acneiform rash (cetuximab, all grades)
RR 6.56 [5.35, 8.03]
2 studies · 1311 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Xerostomia (grades >=3)
RR 1.36 [0.80, 2.31]
2 studies · 1311 participants
GRADE not reported

Show 7 more findings

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Skin toxicity/acneiform rash (nimotuzumab, grades >=3)
RR 0.20 [0.01, 4.05]
1 study · 92 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Skin toxicity/acneiform rash (nimotuzumab, all grades)
RR 1.06 [0.85, 1.31]
1 study · 92 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Dysphagia (all grades)
RR 0.97 [0.92, 1.03]
3 studies · 1403 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Skin toxicity/acneiform rash (cetuximab, grades >=3)
RR 17.72 [8.33, 37.73]
3 studies · 1403 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Dysphagia (grades >=3)
RR 0.93 [0.83, 1.04]
3 studies · 1403 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Mucositis (grades >=3)
RR 1.20 [0.96, 1.51]
4 studies · 1495 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Xerostomia (all grades)
RR 0.97 [0.91, 1.04]
3 studies · 1417 participants
GRADE not reported

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Progression‐free survival · People with squamous cell carcinoma of the oral cavity or oropharynx

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard… showed no clear difference in progression-free survival compared with standard therapy alone (radiotherapy or chemoradiotherapy); GRADE not reported.

2 findings from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Monoclonal antibody + chemoradiotherapy vs chemoradiotherapy alone
HR 1.08 [0.89, 1.32]
1 study · 891 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Monoclonal antibody + radiotherapy vs radiotherapy alone
HR 0.70 [0.54, 0.91]
1 study · 424 participants
GRADE not reported

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Participant satisfaction · People with squamous cell carcinoma of the oral cavity or oropharynx

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
No included studies addressed participant satisfaction (review-wide gap).
0 studies
No studies found

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Costs (direct and indirect) · People with squamous cell carcinoma of the oral cavity or oropharynx

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
No included studies addressed direct and indirect costs to participants and health services (review-wide gap).
0 studies
No studies found

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Overall survival · People with squamous cell carcinoma of the oral cavity or oropharynx

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard… probably leads to lower overall survival compared with standard therapy alone (radiotherapy or chemoradiotherapy) (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
HR 0.82 [0.69, 0.97]
3 studies · 1421 participants
Moderate

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Locoregional control · People with squamous cell carcinoma of the oral cavity or oropharynx

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard… probably leads to lower locoregional control compared with standard therapy alone (radiotherapy or chemoradiotherapy) (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
HR 0.68 [0.52, 0.89]
1 study · 424 participants
Moderate

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Quality of life · People with squamous cell carcinoma of the oral cavity or oropharynx

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
Only one study (Bonner 2006, 424 participants) comprehensively assessed quality of life using EORTC QLQ-C30 (v3.0) and QLQ-H&N35; no statistically significant difference between groups for global health status or any…
1 study · 424 participants
GRADE not reported

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… led to higher adverse effects compared with standard therapy alone (radiotherapy or chemoradiotherapy); GRADE not reported.

9 findings from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Skin toxicity (lapatinib, all grades)
RR 2.02 [1.23, 3.32]
1 study · 67 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Gastrointestinal complaints (gefitinib, all grades)
RR 1.04 [0.98, 1.11]
1 study · 226 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Gastrointestinal complaints (lapatinib, all grades)
RR 15.53 [2.18, 110.55]
1 study · 67 participants
GRADE not reported

Show 6 more findings

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Skin toxicity (erlotinib, all grades)
RR 6.57 [3.60, 12.00]
1 study · 191 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Mucositis (grades >=3)
RR 1.22 [0.96, 1.56]
2 studies · 286 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Mucositis (all grades)
RR 1.03 [0.94, 1.11]
2 studies · 286 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Skin toxicity (gefitinib, all grades)
RR 1.03 [0.82, 1.28]
2 studies · 286 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Gastrointestinal complaints (grades >=3, pooled)
RR 1.11 [0.83, 1.49]
3 studies · 484 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Skin toxicity (grades >=3, pooled)
RR 1.25 [0.54, 2.88]
4 studies · 544 participants
GRADE not reported

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Progression‐free survival · People with squamous cell carcinoma of the oral cavity or oropharynx

It is very uncertain whether tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… changes progression-free survival compared with standard therapy alone (radiotherapy or chemoradiotherapy) (very low certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months
HR 0.80 [0.51, 1.28]
2 studies · 271 participants
Very low

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Overall survival · People with squamous cell carcinoma of the oral cavity or oropharynx

It is very uncertain whether tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… changes overall survival compared with standard therapy alone (radiotherapy or chemoradiotherapy) (very low certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months
HR 0.99 [0.62, 1.57]
2 studies · 271 participants
Very low

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Disease-free survival · People with squamous cell carcinoma of the oral cavity or oropharynx

It is very uncertain whether tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… changes disease-free survival compared with standard therapy alone (radiotherapy or chemoradiotherapy) (very low certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Gefitinib + radiotherapy (oral cavity)
HR 1.51 [0.61, 3.71]
1 study · 60 participants
Very low

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Locoregional control · People with squamous cell carcinoma of the oral cavity or oropharynx

It is very uncertain whether tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… changes locoregional control compared with standard therapy alone (radiotherapy or chemoradiotherapy) (very low certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months
HR 0.89 [0.53, 1.49]
2 studies · 271 participants
Very low