What do systematic reviews say?

Hypofractionated radiotherapy vs daily conventionally fractionated radiotherapy

• External beam radiation dose escalation for high grade glioma 2020 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 848 participants
  GRADE not reported

Daily conventionally fractionated radiotherapy vs supportive care

• External beam radiation dose escalation for high grade glioma 2020 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 289 participants
  GRADE not reported

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

• 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

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

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… led to higher adverse effects compared with standard therapy alone (radiotherapy or chemoradiotherapy); 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 (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

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs High-content fluoride toothpaste (1350 ppm)

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  14 to 36 months
  Adverse effects were an outcome of interest in the study conducting this comparison, however no mention was made of the presence or absence of any adverse events
  1 study · 220 participants
  Very low

Hyperbaric oxygen therapy (HBO) following extractions vs penicillin G

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  6 months
  Adverse effects were an outcome of interest in the study conducting this comparison, however no mention was made of the presence or absence of any adverse events
  1 study · 74 participants
  Very low

Hyperbaric oxygen vs air breathing

Hyperbaric oxygen leads to higher adverse effects compared with air breathing (high certainty).

• Hyperbaric oxygenation for tumour sensitisation to radiotherapy 2018 · Cochrane Headline outcomes only
  RR 2.05 [1.22, 3.46]
  3 studies · 456 participants
  High

Hyperbaric oxygen vs air breathing to enhance the effectiveness of radiotherapy

Hyperbaric oxygen probably leads to higher adverse effects compared with air breathing to enhance the effectiveness of radiotherapy (moderate certainty).

• Hyperbaric oxygenation for tumour sensitisation to radiotherapy 2018 · Cochrane Headline outcomes only
  RR 2.64 [1.65, 4.23]
  4 studies · 323 participants
  Moderate

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No evidence of a difference in reported adverse events across the three trials (nausea, fever, constipation, diarrhoea, headache, fatigue and others)
  3 studies
  GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Increased hypotension with intravenous delivery (20% vs 8%; P = 0.007); skin rash (10% vs 22%; P = 0.012) and local pain at injection site (0% vs 8%; P = 0.001) worse with subcutaneous; inconclusive for…
  1 study
  GRADE not reported

PRP (platelet-rich plasma) in cellulose foam placed in extraction socket vs placebo, no treatment or surveillance only

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  2 weeks to 12 months
  This comparison was only made in 1 study: mean pain scores at 2 weeks, 2, 6, 9, and 12 months showed no 'significant' differences between the 2 groups (self-reported Likert scale 1 to 10; difference at 2 weeks P =…
  1 study · 44 participants
  Very low

Brachytherapy vs brachytherapy plus radiotherapy

Brachytherapy showed no clear difference in adverse effects compared with brachytherapy plus radiotherapy (moderate certainty).

• Interventions for dysphagia in oesophageal cancer 2014 · Cochrane Headline outcomes only
  OR 1.17 [0.44, 3.15]
  2 studies · 554 participants
  Moderate

Amifostine vs no treatment/placebo

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Alopecia, skin toxicity, hot flush, drowsiness, sneezing, hiccupping, dizziness and fatigue reported narratively or only for the amifostine group; insufficient evidence of a difference
  Studies not reported
  GRADE not reported

Pilocarpine vs no treatment/placebo

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No evidence of a difference for any other adverse event (nausea, vomiting, chilling, headache, lacrimation, dysphasia, weakness, nervousness, rhinitis, blurred vision, urinary frequency, dizziness, palpitation, skin…
  Studies not reported
  GRADE not reported

Combined HBO and perioperative antibiotics prior to dental implant therapy vs antibiotics alone

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  1 year
  This comparison was only made in 1 study which reported no serious adverse events associated with HBO therapy. Quality of life measures (oral status, functioning, satisfaction) showed emotional functioning and pain…
  1 study · 26 participants
  Very low

Hyperbaric oxygen vs air breathing

Hyperbaric oxygen leads to higher adverse effects compared with air breathing (high certainty).

• Hyperbaric oxygenation for tumour sensitisation to radiotherapy 2018 · Cochrane Headline outcomes only
  RR 2.35 [1.66, 3.33]
  7 studies · 779 participants
  High

Brachytherapy vs brachytherapy plus radiotherapy

Brachytherapy showed no clear difference in adverse effects ‐ stricture compared with brachytherapy plus radiotherapy (high certainty).

• Interventions for dysphagia in oesophageal cancer 2014 · Cochrane Headline outcomes only
  OR 1.43 [0.16, 12.85]
  2 studies · 277 participants
  High

Whole brain radiation therapy (WBRT) + stereotactic radiosurgery (SRS) vs WBRT

• Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  High

Radiosurgery alone vs WBRT and radiosurgery

• Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  High

WBRT with radiosensitisers (radiosen) vs WBRT

• Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  High