Findings

What do systematic reviews say?

1,104 questions · 1,200 findings · 23 reviews · Oral medicine and oral cancer

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No studies found 143 · 11.9%GRADE not reported 760 · 63.3%Very low 201 · 16.8%Low 66 · 5.5%Moderate 29 · 2.4%High 1 · 0.1%

Chinese medicine vs no treatment/placebo

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

Amifostine (intravenous) vs Amifostine (subcutaneous)

Quality of life · 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 on either quality of life or other oral related symptoms were reported.
0 studies
No studies found

Bethanechol vs Artificial saliva

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

Bethanechol led to higher salivary flow rate (stimulated, ml/min) compared with artificial saliva; GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
8 to 40 weeks postRT
MD 0.21 [0.01, 0.41]
1 study · 29 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
MD 0.13 [-0.03, 0.29]
1 study · 32 participants
GRADE not reported

Epidermal growth factor (EGF), oral spray vs placebo

Adverse events · Adults with cancer receiving treatment

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Adverse events narratively reported; no serious events attributed to EGF (not GRADE-rated)
2 studies
GRADE not reported

Bethanechol vs placebo

Side effects · 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
No statistical difference between groups in bethanechol-related toxicity; no patient experienced severe (grade 3) toxicity (Jaguar 2015)
1 study
GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

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

Amifostine (intravenous) led to lower xerostomia (grade >= 2, 0-4 scale) compared with amifostine (subcutaneous); GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
RR 0.61 [0.42, 0.88]
1 study · 127 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 1.03 [0.76, 1.40]
1 study · 263 participants
GRADE not reported

Antiseptic mouthrinse vs placebo

Side effects · 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
No relevant adverse events were reported in any group (Lanzos 2010)
1 study
GRADE not reported

Granulocyte-macrophage colony-stimulating factor (GM-CSF), mouthwash vs Sucralfate mouthwash

Oral mucositis (moderate to severe) · Adults receiving radiotherapy to the head and neck

Granulocyte-macrophage colony-stimulating factor (GM-CSF), mouthwash showed no clear difference in oral mucositis (moderate to severe) compared with sucralfate 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
RT to head and neck
RR 0.96 [0.80, 1.14]
1 study · 40 participants
GRADE not reported

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

Interruptions to cancer treatment (unscheduled radiotherapy breaks of 5 or more days) · Adults with cancer receiving treatment

Keratinocyte growth factor (KGF; palifermin or repifermin),… showed no clear difference in interruptions to cancer treatment (unscheduled radiotherapy breaks… 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
RT to head and neck with cisplatin/fluorouracil
RR 1.01 [0.65, 1.59]
3 studies · 473 participants
GRADE not reported

Bethanechol vs placebo

Xerostomia (grade >= 2, 0-3 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Bethanechol led to lower xerostomia (grade >= 2, 0-3 scale) compared with placebo; GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.43 [0.28, 0.66]
1 study · 84 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 0.81 [0.65, 1.01]
1 study · 84 participants
GRADE not reported

Bethanechol vs placebo

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

Bethanechol showed no clear difference in salivary flow rate (stimulated, ml/min) compared with 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
2 months postRT
MD 0.15 [-0.03, 0.33]
1 study · 97 participants
GRADE not reported

Pilocarpine vs no treatment/placebo

Salivary flow rate (stimulated) · 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
Any time point
No evidence of a difference between treatment groups for stimulated salivary flow at any time point (Analysis 1.5)
8 studies
GRADE not reported

Zinc vs placebo

Taste acuity improvement - objective outcome (continuous) - taste recognition (cross-over trial) · Patients with taste disturbances (dysgeusia/hypogeusia; idiopathic, zinc-deficient, or secondary to chronic renal failure)

It is very uncertain whether zinc supplements (zinc sulphate, zinc gluconate, zinc picolinate,… changes taste acuity improvement - objective outcome (continuous) - taste… compared with placebo (very low certainty).

1 finding from 1 review

Interventions for managing taste disturbances 2017 · Cochrane All outcomes
6 months · Children with chronic renal failure
MD 3.00 [0.66, 5.34]
1 study · 14 participants
Very low

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

Oral mucositis (moderate to severe) · Children with acute lymphoblastic leukaemia receiving chemotherapy alone

Keratinocyte growth factor (KGF), intravenous led to lower oral mucositis (moderate to severe) 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 0.12 [0.05, 0.28]
1 study · 90 participants
GRADE not reported

Amifostine vs no treatment/placebo

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

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

Bethanechol vs placebo

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

Bethanechol led to higher salivary flow rate (unstimulated, ml/min) compared with 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
2 months postRT
MD 0.19 [0.06, 0.32]
1 study · 97 participants
GRADE not reported

Antimicrobial lozenge 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

Venalot Depot (coumarin plus troxerutin) vs placebo

Survival (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
Unable to use the data on locoregional control (Grotz 2001)
1 study
GRADE not reported

Keratinocyte growth factor (KGF), higher dose/regimen vs Keratinocyte growth factor (KGF), different (lower) dose/regimen

Oral mucositis (any severity) · Adults with cancer receiving treatment

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Some inconsistent evidence from which no conclusions can be drawn regarding different dosages of KGF (Analyses 2.1 to 2.8); no pooled estimate reported
Studies not reported
GRADE not reported

Zinc vs placebo

Health‐related quality of life · Patients with taste disturbances (dysgeusia/hypogeusia; idiopathic, zinc-deficient, or secondary to chronic renal failure)

1 finding from 1 review

Interventions for managing taste disturbances 2017 · Cochrane All outcomes
Results (health-related quality of life): None of the studies reported data on health-related quality of life. Heckmann 2005 (zinc) reported that signs of depression were less severe (Beck Depression Inventory P<0.05;…
1 study
GRADE not reported