What do systematic reviews say?

COE with blood/salivary (biomarker) analysis vs Conventional oral examination (COE) alone

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible studies; planned comparative analysis (COE vs COE with blood/salivary analysis) not populated in this version.
  0 studies
  No studies found

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Concomitant (concurrent) chemoradiotherapy led to lower locoregional control, concurrent chemoradiotherapy (platinum +… 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
  RR 0.75 [0.61, 0.93]
  3 studies
  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

Chemotherapy (any regimen; added to, or compared with, locoregional treatment) vs Locoregional treatment and/or an alternative chemotherapy regimen

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Harms/toxicity were planned but very little quantitative data suitable for analysis were found; toxicity reported narratively and not quantified or GRADE-rated.
  Studies not reported
  GRADE not reported

COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs Conventional oral examination (COE) alone

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible studies; planned comparative analysis (COE vs COE with light-based detection) not populated in this version.
  0 studies
  No studies found

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

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

Surgery +/- radiotherapy + (adjuvant) chemotherapy probably leads to lower overall survival, adjuvant concurrent chemoradiation vs adjuvant… 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 0.84 [0.72, 0.98]
  4 studies · 1097 participants
  Moderate

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

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction cisplatin + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone (low certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.71 [0.37, 1.35]
  2 studies · 389 participants
  Low

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
  Locoregional control reported in 12 studies; not pooled. Olasz 2000 RR 0.50 (0.26 to 0.96); Prevost 2005 RR 1.48 (1.04 to 2.11); Molinari 1982 RR 0.35 (0.19 to 0.66).
  12 studies
  GRADE not reported

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Concomitant (concurrent) chemoradiotherapy probably leads to lower overall survival, concurrent chemoradiotherapy vs radiotherapy alone… compared with radiotherapy alone (non-resectable tumours) (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.74 [0.67, 0.83]
  24 studies · 2852 participants
  Moderate

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Sensitivity 0.50 [0.12, 0.88]
  1 study · 3895 participants
  Moderate

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Sensitivity 0.40 [0.05, 0.85]
  1 study · 4080 participants
  Moderate

Mixed beam (neutron and photon) radiotherapy vs Conventional photon radiotherapy

Mixed beam (neutron and photon) radiotherapy showed no clear difference in locoregional control compared with conventional photon radiotherapy; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 1.04 [0.84, 1.29]
  1 study · 327 participants
  GRADE not reported

Altered fractionation radiotherapy (hyperfractionated and/or accelerated) vs Conventional (standard) fractionation radiotherapy

Hyperfractionated/accelerated radiotherapy led to lower locoregional control compared with conventional (standard) fractionation radiotherapy; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 0.84 [0.72, 0.99]
  4 studies · 1071 participants
  GRADE not reported
• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 0.79 [0.70, 0.89]
  11 studies
  GRADE not reported

Accelerated radiotherapy with concomitant boost vs Conventional (standard) fractionation radiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Accelerated/boost vs conventional, locoregional control: IPD from one trial (Fu 2000); a statistically significant difference in favour of the accelerated schedule with boost was shown (Analysis 1.2). No numeric…
  1 study
  GRADE not reported

Low dose rate interstitial radiotherapy vs High dose rate interstitial radiotherapy

Low dose rate interstitial radiotherapy showed no clear difference in locoregional control compared with high dose rate interstitial radiotherapy; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 1.00 [0.16, 6.44]
  1 study · 59 participants
  GRADE not reported

Hyperfractionated/accelerated split-course radiotherapy vs Accelerated radiotherapy with concomitant boost

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Hyperfractionated/accelerated split course vs accelerated boost (Fu 1995, feasibility study, 75 participants): authors report no significant difference in total mortality; data not presented in a way that allows…
  1 study · 75 participants
  GRADE not reported

Altered fractionation radiotherapy (hyperfractionated and/or accelerated) vs Conventional (standard) fractionation radiotherapy

Altered fractionation radiotherapy (hyperfractionated and/or… showed no clear difference in disease free survival compared with conventional (standard) fractionation radiotherapy; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 0.85 [0.70, 1.03]
  8 studies
  GRADE not reported
• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Hyperfractionated/accelerated vs conventional, disease free survival: one trial (Poulsen 2001); no statistically significant difference (Analysis 1.3). No pooled estimate.
  1 study
  GRADE not reported

Neutron radiotherapy vs Conventional photon radiotherapy

Neutron radiotherapy showed no clear difference in disease free survival compared with conventional photon radiotherapy; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes

  5 years
  RR 0.63 [0.36, 1.09]
  1 study
  GRADE not reported