What do systematic reviews say?

Chemotherapy regimen A (+/- locoregional treatment) vs Chemotherapy regimen B (+/- locoregional treatment)

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Induction cisplatin+5-FU+docetaxel vs cisplatin+5-FU: disease-free survival HR 0.72 (95% CI 0.57 to 0.91, P = 0.006; Vermorken 2007). Prior to concurrent chemoradiation: Posner 2007 HR 0.71 (0.56 to 0.90, P = 0.005).…
  2 studies
  GRADE not reported

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

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

• 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

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Surgery +/- radiotherapy + (adjuvant) chemotherapy led to lower disease-free survival, adjuvant concurrent chemoradiation vs… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy…; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.84 [0.72, 0.97]
  4 studies
  GRADE not reported

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Induction chemotherapy plus locoregional treatment (radiotherapy… led to lower disease-free survival, induction platinum + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.78 [0.63, 0.97]
  3 studies · 332 participants
  GRADE not reported

Surgery plus radiotherapy vs Radiotherapy alone

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Disease-free survival: not reported.
  0 studies
  No studies found

Surgery plus radiotherapy vs Chemotherapy (chemoradiotherapy)

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  oral cavity
  Disease-free survival: not reported (Iyer 2015).
  0 studies
  No studies found

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

• 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

Surgery vs Radiotherapy alone

Surgery showed no clear difference in disease-free survival (new disease, progression, and mortality) compared with radiotherapy alone (low certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  3 years
  HR 1.07 [0.27, 4.22]
  1 study · 68 participants
  Low