What do systematic reviews say?

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

Surgery +/- radiotherapy + (adjuvant) chemotherapy showed no clear difference in overall survival, adjuvant chemotherapy vs observation alone… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy… (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.95 [0.73, 1.22]
  5 studies · 353 participants
  Moderate

Polaprezinc vs Azulene oral rinse

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Tumour response by RECIST criteria reported for a specific group of patients only; no usable survival data (Watanabe 2010)
  1 study
  GRADE not reported

Biperiden plus pilocarpine vs no treatment

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
  Survival not 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 survival data were reported.
  0 studies
  No studies found

Selenium vs no intervention

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 survival data were reported.
  0 studies
  No studies found

Antimicrobial lozenge 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 survival data were reported.
  0 studies
  No studies found

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 survival data were reported.
  0 studies
  No studies found

Bethanechol vs Artificial saliva

Bethanechol showed no clear difference in overall survival compared with artificial saliva; GRADE not reported.

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

  40 weeks postRT
  RR 1.59 [0.43, 5.84]
  1 study · 43 participants
  GRADE not reported

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

Palifermin showed no clear difference in overall survival compared with placebo (moderate certainty).

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

  42 to 72 months from baseline
  HR 1.00 [0.72, 1.39]
  3 studies
  Moderate

Amifostine (intravenous) vs Amifostine (subcutaneous)

Amifostine (intravenous) showed no clear difference in overall survival compared with amifostine (subcutaneous); GRADE not reported.

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

  48 months postRT
  HR 1.36 [0.89, 2.10]
  1 study
  GRADE not reported

Pilocarpine vs no treatment/placebo

It is very uncertain whether pilocarpine changes overall survival 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
  RR 1.07 [0.80, 1.43]
  1 study · 60 participants
  Very low

Chinese medicine vs no treatment/placebo

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

  12 months postRT
  Insufficient evidence to determine any effect on overall survival (Hu 2005; Analysis 6.4)
  1 study
  GRADE not reported

Amifostine vs no treatment/placebo

It is very uncertain whether amifostine changes overall survival 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 to 24 months postRT
  HR 1.18 [0.85, 1.66]
  2 studies · 271 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

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

Palifermin showed no clear difference in progression-free survival compared with placebo; GRADE not reported.

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

  42 to 72 months from baseline
  HR 1.06 [0.80, 1.42]
  3 studies
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in progression-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

  12 to 24 months postRT
  HR 0.94 [0.70, 1.27]
  2 studies · 247 participants
  GRADE not reported

Venalot Depot (coumarin plus troxerutin) vs placebo

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Unable to use the data on locoregional control (Grotz 2001)
  1 study
  GRADE not reported

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
  Insufficient evidence reported on overall survival or locoregional tumour control (Analysis 4.2; 4.3)
  1 study
  GRADE not reported