What do systematic reviews say?

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

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

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).

• 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

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in disease-free survival compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  24 months postRT
  RR 0.94 [0.73, 1.21]
  1 study · 170 participants
  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