What do systematic reviews say?

Chemotherapy (any regimen; added to, or compared with, locoregional treatment) vs Locoregional treatment and/or an alternative chemotherapy regimen

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Harms/toxicity were planned but very little quantitative data suitable for analysis were found; toxicity reported narratively and not quantified or GRADE-rated.
  Studies not reported
  GRADE not reported

Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Non-specific immunotherapy (recombinant interleukin-2 or BCG cell… showed no clear difference in adverse effects compared with standard therapy alone; GRADE not reported.

• Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes

  24 to 70 months · Moderate to severe chills (BCG-CWP, all grades)
  RR 11.00 [0.67, 179.29]
  1 study · 24 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 · Nausea/vomiting (rIL-2, grades >=3)
  RR 3.40 [0.15, 77.34]
  1 study · 30 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 · Stomatitis (rIL-2, all grades)
  RR 1.47 [0.75, 2.90]
  1 study · 30 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

Psychological therapies (cognitive therapy) vs placebo

The review found no eligible studies for this question.

• Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes

  short-term (up to 3 months)
  SoF8: No included study reported the occurrence of adverse events.
  0 studies
  No studies found

Low‐level laser therapy vs placebo

The review found no eligible studies for this question.

• Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes

  short-term (up to 3 months)
  SoF6: No included study reported the occurrence of adverse events.
  0 studies
  No studies found

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

Prophylactic valaciclovir (lower dose) vs Prophylactic valaciclovir (higher dose)

• Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer 2009 · Cochrane All outcomes
  One study reported adverse effects (Warkentin 2002). Twenty patients allocated to receive high dose valaciclovir reported adverse effects (42%); for the low dose group this number was 27 (52%). Adverse effects were…
  1 study · 100 participants
  GRADE not reported

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

Pilocarpine vs placebo

• Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy 2015 · Cochrane All outcomes
  Johnson 1993 (5 mg tds): sweating 37%, headache 15%, urinary frequency 14%, vasodilatation 12%, dizziness 10%, dyspepsia 10%, nausea 8%, asthenia 8%, diarrhoea 5%; 6% withdrew at 5 mg tds and 29% at 10 mg tds. LeVeque…
  2 studies · 278 participants
  GRADE not reported

Pilocarpine vs Artificial saliva

• Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy 2015 · Cochrane All outcomes
  Davies 1994: main side effects with pilocarpine were nausea 20%, sweating 15%, lacrimation 10%. One participant definitely withdrew because of side effects; another may have.
  1 study · 20 participants
  GRADE not reported