What do systematic reviews say?

Radiotherapy (morning) vs Afternoon radiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Bjarnason 2009: no statistically significant difference in quality of life scores (data not reported). Morning radiotherapy was associated with significantly less weight loss after 5 months.
  1 study · 216 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
  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

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in quality of life compared with no treatment/placebo; GRADE not reported.

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

  End of RT; up to 3 months postRT
  MD 0.52 [-0.02, 1.06]
  1 study · 233 participants
  GRADE not reported

Antiseptic mouthrinse vs placebo

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No quality of life data were reported.
  0 studies
  No studies found

Bethanechol vs placebo

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No data on either quality of life or other oral related symptoms were reported.
  0 studies
  No studies found

Chinese medicine vs no treatment/placebo

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

  End of intervention to 3 months postRT
  Insufficient evidence to determine any effect on quality of life (Lin 2014; Analysis 6.5)
  1 study
  GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No data on either quality of life or other oral related symptoms were reported.
  0 studies
  No studies found

Venalot Depot (coumarin plus troxerutin) vs placebo

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No data on either quality of life or other oral related symptoms were reported.
  0 studies
  No studies found

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

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

  End of RT and 6, 12, 18, 24 months postRT
  No significant differences between the three treatment arms (Jellema 2006)
  1 study
  GRADE not reported

Bethanechol vs Artificial saliva

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No data on either quality of life or other oral related symptoms were reported.
  0 studies
  No studies found

Acupuncture vs sham

The review found no eligible studies for this question.

• Interventions for the management of dry mouth: non‐pharmacological interventions 2013 · Cochrane All outcomes
  no estimate extracted
  0 studies
  No studies found

Phenytoin mouthrinse vs placebo

Phenytoin mouthrinse led to lower quality of life compared with placebo; GRADE not reported.

• Interventions for treating oral mucositis for patients with cancer receiving treatment 2010 · Cochrane All outcomes

  7 days
  MD -15.10 [-26.04, -4.16]
  1 study · 12 participants
  GRADE not reported

Pilocarpine vs no treatment/placebo

It is very uncertain whether pilocarpine changes quality of life (McMaster HNRQ, 1-7 scale) compared with no treatment/placebo (very low certainty).

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

  Up to and including 6 months postRT
  MD 0.20 [-0.19, 0.59]
  1 study · 90 participants
  Very low

Antimicrobial lozenge vs placebo

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

  Over 6 months
  Insufficient evidence of a difference for global quality of life, mouth pain RR 0.94 (95% CI 0.66 to 1.33), sore/burning mouth RR 0.95 (95% CI 0.68 to 1.35), throat pain RR 0.79 (95% CI 0.56 to 1.12) (Duncan 2005)
  1 study
  GRADE not reported

Amifostine vs no treatment/placebo

It is very uncertain whether amifostine changes quality of life (Patient Benefit Questionnaire, 10-point scale) compared with no treatment/placebo (very low certainty).

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

  12 months postRT
  MD 0.70 [0.20, 1.20]
  1 study · 180 participants
  Very low

Selenium vs no intervention

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

  6 weeks after end of RT
  Insufficient evidence of differences for loss of taste or dysphagia; data largely unusable (no standard deviations). Ageusia milder in selenium group (not significant); dysphagia significant only at week 7 (P = 0.05)…
  1 study
  GRADE not reported

Any antifungal intervention for the treatment of oral candidiasis vs Placebo, no treatment, or another active antifungal intervention

The review found no eligible studies for this question.

• Interventions for treating oral candidiasis for patients with cancer receiving treatment 2010 · Cochrane All outcomes
  None of the studies reported: relief of pain, relief of dysphagia, incidence of systemic infection, amount of analgesia, days stay in hospital, cost of oral care, patient quality of life.
  0 studies
  No studies found

Antifungal drugs absorbed from GI tract (fluconazole, ketoconazole, itraconazole) vs placebo or no treatment

The review found no eligible studies for this question.

• Interventions for preventing oral candidiasis for patients with cancer receiving treatment 2007 · Cochrane All outcomes
  No trial reported this planned secondary outcome for any comparison in this review
  Studies not reported
  No studies found

Commercial mouthcare system (Biotene Oral Balance / Xerostom) vs Usual care or CMC-based control

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Ship 2007 reported xerostomia-related quality of life; no usable comparative data.
  1 study
  GRADE not reported

Commercial mouthcare system (Biotene Oral Balance / Xerostom) vs Bioxtra mouthcare system

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between systems for overall xerostomia-related quality of life (15-item survey). Bioxtra rated better for taste; no difference for mouth 'feel'. Trial likely underpowered.
  1 study · 20 participants
  GRADE not reported