Findings

What do systematic reviews say?

1,183 questions · 1,283 findings · 30 reviews · Oral medicine and oral cancer

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No studies found 164 · 12.8%GRADE not reported 802 · 62.5%Very low 209 · 16.3%Low 71 · 5.5%Moderate 36 · 2.8%High 1 · 0.1%

Biperiden plus pilocarpine vs no treatment

Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Survival not reported.
0 studies
No studies found

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

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
None of the trials evaluating palifermin provided data on salivary flow rates.
0 studies
No studies found

Epidermal growth factor (EGF), oral spray vs placebo

Oral mucositis (moderate to severe) · Adults with cancer receiving treatment

Epidermal growth factor (EGF), oral spray showed no clear difference in oral mucositis (moderate to severe) compared with placebo; GRADE not reported.

2 findings from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Chemoradiotherapy to the head and neck
RR 1.06 [0.78, 1.43]
1 study · 136 participants
GRADE not reported
Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Radiotherapy to the head and neck
RR 0.67 [0.45, 0.99]
1 study · 103 participants
GRADE not reported

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

Oral mucositis (any severity) · Children with acute lymphoblastic leukaemia receiving chemotherapy alone

Keratinocyte growth factor (KGF), intravenous led to lower oral mucositis (any severity) compared with chlorhexidine mouthwash; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Children
RR 0.67 [0.54, 0.85]
1 study · 90 participants
GRADE not reported

Amifostine vs no treatment/placebo

Dysgeusia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine led to lower dysgeusia (grade >= 2, 0-4 scale) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.24 [0.10, 0.61]
1 study · 28 participants
GRADE not reported

Zinc supplements vs Acupuncture

Outcome not reported · Patients with taste disturbances (dysgeusia/hypogeusia; idiopathic, zinc-deficient, or secondary to chronic renal failure)

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for managing taste disturbances 2017 · Cochrane All outcomes
Authors' conclusions: We were unable to draw any conclusions regarding the superiority of zinc supplements or acupuncture as none of the trials compared these interventions.
0 studies
No studies found

Granulocyte-colony stimulating factor (G-CSF; pegfilgrastim, single dose) vs Granulocyte-colony stimulating factor (G-CSF; filgrastim, multiple doses)

Normalcy of diet (total parenteral nutrition) · Children receiving bone marrow/stem cell transplantation after conditioning therapy for mixed cancers

Granulocyte-colony stimulating factor (G-CSF; pegfilgrastim, single… showed no clear difference in normalcy of diet (total parenteral nutrition) compared with granulocyte-colony stimulating factor (G-CSF; filgrastim, multiple…; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Children
RR 1.00 [0.94, 1.06]
1 study · 61 participants
GRADE not reported

Selenium vs no intervention

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
6 weeks after end of RT
No evidence that selenium reduced xerostomia; data unusable (bar charts with no standard deviations) (Buntzel 2010)
1 study
GRADE not reported

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

Overall survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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

1 finding from 1 review

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

G‐CSF vs placebo or no treatment

Oral mucositis (severe) · Adults with cancer receiving treatment

Granulocyte-colony stimulating factor (G-CSF) may leads to lower oral mucositis (severe) compared with placebo or no treatment (low certainty).

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RT to head and neck
RR 0.37 [0.15, 0.87]
2 studies · 54 participants
Low

Antiseptic mouthrinse vs placebo

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Salivary flow rate was only reported during radiotherapy (i.e. not at any of the time points of interest); no usable data (Lanzos 2010)
1 study
GRADE not reported

Erythropoietin mouthwash vs placebo

Oral mucositis (moderate to severe) · Adults receiving bone marrow/stem cell transplantation after conditioning therapy for haematological cancers

Erythropoietin mouthwash led to lower oral mucositis (moderate to severe) compared with placebo; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RR 0.43 [0.24, 0.79]
1 study · 80 participants
GRADE not reported

Pilocarpine vs no treatment/placebo

Salivary flow rate (unstimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

It is very uncertain whether pilocarpine changes salivary flow rate (unstimulated) compared with no treatment/placebo (very low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
MD -0.06 [-0.23, 0.11]
1 study · 24 participants
Very low

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

Survival (overall survival and locoregional control) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

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

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

Quality of life · Adults with cancer receiving treatment

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
No studies reported this outcome (planned secondary outcome not measured by any study in the review)
0 studies
No studies found

Biperiden plus pilocarpine vs no treatment

Side effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data were reported on side effects.
0 studies
No studies found

Amifostine (intravenous) vs Amifostine (subcutaneous)

Locoregional control · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine (intravenous) showed no clear difference in locoregional tumour control compared with amifostine (subcutaneous); GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
48 months postRT
HR 1.34 [0.76, 2.36]
1 study
GRADE not reported

Bethanechol vs placebo

Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

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

Amifostine vs no treatment/placebo

Cost (mean per-patient supportive care costs) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
Mean per-patient supportive care costs lower with amifostine (USD 4401) than control (USD 5873); P = 0.02 (Buntzel 1998 / Bennett 2001)
1 study · 28 participants
GRADE not reported

Pilocarpine vs no treatment/placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Pilocarpine led to lower xerostomia (objective, LENT-SOMA scale) compared with no treatment/placebo; GRADE not reported.

3 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
6 months postRT
MD -0.40 [-0.69, -0.11]
1 study · 39 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT; 3 months postRT
RR 1.00 [0.92, 1.08]
2 studies · 48 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 6 months postRT
SMD -0.35 [-1.04, 0.33]
2 studies · 126 participants
Very low