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Evidence found and GRADE certainty

927 questions · 1,014 findings · 29 reviews · Oral medicine and oral cancer

No studies found 123 · 12.1%GRADE not reported 604 · 59.6%Very low 193 · 19%Low 58 · 5.7%Moderate 35 · 3.5%High 1 · 0.1%

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

Total mortality · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

Accelerated radiotherapy with concomitant boost showed no clear difference in total mortality compared with conventional (standard) fractionation radiotherapy; GRADE not reported.

1 finding from 1 review

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

Disease-free survival · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…
1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs Accelerated radiotherapy

Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

Split-course radiotherapy showed no clear difference in locoregional control compared with accelerated radiotherapy; GRADE not reported.

1 finding from 1 review

Gelclair vs Sucralfate and mucaine

Mucositis severity (mild to moderate) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Gelclair showed no clear difference in mucositis severity (mild to moderate) compared with sucralfate and mucaine; GRADE not reported.

1 finding from 1 review

Pre-operative and post-operative radiotherapy vs Post-operative radiotherapy alone

Disease-free survival · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

Pre-operative and post-operative radiotherapy showed no clear difference in disease free survival compared with post-operative radiotherapy alone; GRADE not reported.

1 finding from 1 review

Hyperfractionated radiotherapy vs Conventional (standard) fractionation radiotherapy

Total mortality · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

Hyperfractionated radiotherapy led to lower total mortality compared with conventional (standard) fractionation radiotherapy; GRADE not reported.

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs Accelerated radiotherapy

Disease-free survival · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

Split-course radiotherapy showed no clear difference in disease free survival compared with accelerated radiotherapy; GRADE not reported.

1 finding from 1 review

Pre-operative and post-operative radiotherapy vs Post-operative radiotherapy alone

Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

Pre-operative and post-operative radiotherapy showed no clear difference in locoregional control compared with post-operative radiotherapy alone; GRADE not reported.

1 finding from 1 review

Morphine via pharmacokinetically based PCA (PKPCA) vs Morphine via patient-controlled analgesia (PCA)

Daily mean opiate intake per hour · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Morphine via pharmacokinetically based PCA (PKPCA) led to higher daily mean opiate intake per hour compared with morphine via patient-controlled analgesia (PCA); GRADE not reported.

1 finding from 1 review

Neutron radiotherapy vs Conventional photon radiotherapy

Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

Neutron radiotherapy showed no clear difference in locoregional control compared with conventional photon radiotherapy; GRADE not reported.

1 finding from 1 review

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

All‐cause mortality · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

It is very uncertain whether altered fractionation radiotherapy (hyperfractionated and/or… changes mortality compared with conventional (standard) fractionation radiotherapy (very low certainty).

2 findings from 1 review

Patient-controlled analgesia (PCA) pethidine vs Staff-controlled delivery of pethidine

Average pain scores (0-100 VAS) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Patient-controlled analgesia (PCA) pethidine showed no clear difference in average pain scores (0-100 VAS) compared with staff-controlled delivery of pethidine; GRADE not reported.

1 finding from 1 review

Partially absorbed antifungal drug (e.g., clotrimazole, miconazole) vs Drug not absorbed from GI tract (e.g., nystatin, amphotericin B)

Outcome not reported · Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis

The review found no eligible studies for this question.

1 finding from 1 review

Accelerated radiotherapy (no split, boost or hyperfractionation) vs Conventional (standard) fractionation radiotherapy

Total mortality · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…
1 finding from 1 review

Chlorhexidine mouthwash vs Salt and soda mouthwash

Time to heal mucositis (days) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Chlorhexidine mouthwash showed no clear difference in time to heal mucositis (days) compared with salt and soda mouthwash; GRADE not reported.

1 finding from 1 review

Hyperfractionated radiotherapy vs Conventional (standard) fractionation radiotherapy

Disease-free survival · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…
1 finding from 1 review

'Magic' mouthwash (lidocaine, diphenhydramine, aluminium hydroxide) vs Salt and soda mouthwash

Average pain scores (0-100 VAS) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

'Magic' mouthwash (lidocaine, diphenhydramine, aluminium hydroxide) showed no clear difference in average pain scores (0-100 VAS) compared with salt and soda mouthwash; GRADE not reported.

1 finding from 1 review

Lower total dose radiotherapy (67.2 Gy over 5.6 weeks) vs conventional dose RT

Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and neck cancer trials…

Lower total dose radiotherapy (67.2 Gy over 5.6 weeks) showed no clear difference in locoregional control compared with conventional/standard total dose radiotherapy (72 Gy); GRADE not reported.

1 finding from 1 review