Findings

What do systematic reviews say?

488 questions · 522 findings · 13 reviews · Oral medicine and oral cancer

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No studies found 53 · 10.2%GRADE not reported 412 · 78.9%Very low 19 · 3.6%Low 25 · 4.8%Moderate 13 · 2.5%High 0 · 0%

Surgery plus radiotherapy vs Chemotherapy (chemoradiotherapy)

Locoregional recurrence · Adults with oral cavity or oropharyngeal cancer

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
oral cavity
Locoregional recurrence: reported difference between groups not statistically significant (P=0.355), but no useable data; 32 participants (1 RCT, Iyer 2015).
1 study · 32 participants
Very low

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

Overall survival, post-surgery chemotherapy vs surgery alone (no radiotherapy) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

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).

1 finding from 1 review

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

Pre-operative radiotherapy (plus surgery) vs surgery

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…

Pre-operative radiotherapy (plus surgery) showed no clear difference in total mortality compared with surgery alone; GRADE not reported.

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
HR 0.83 [0.64, 1.07]
1 study
GRADE not reported

Pre-operative radiotherapy (plus surgery) vs surgery

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 radiotherapy (plus surgery) showed no clear difference in locoregional control compared with surgery alone; GRADE not reported.

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
Timing unclear
RR 0.63 [0.28, 1.46]
1 study
GRADE not reported

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

Overall survival, induction cisplatin + 5-fluorouracil + docetaxel prior to concurrent chemoradiation (cisplatin) vs concurrent chemoradiation (cisplatin) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

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

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 1.08 [0.80, 1.44]
3 studies · 760 participants
Low

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

Locoregional control · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Induction chemotherapy plus locoregional treatment (radiotherapy… led to lower locoregional control, induction cisplatin + 5-fluorouracil +… compared with locoregional treatment (radiotherapy and/or surgery) alone; GRADE not reported.

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
RR 0.80 [0.64, 0.99]
3 studies
GRADE not reported

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

Overall survival, induction platinum + 5-fluorouracil prior to surgery vs surgery alone · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

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

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
HR 1.06 [0.71, 1.60]
1 study · 198 participants
Low

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

Overall survival, induction cisplatin + 5-fluorouracil prior to concurrent chemoradiation (cisplatin) vs concurrent chemoradiation (cisplatin) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

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).

1 finding from 1 review

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

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Recurrence · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
Recurrence: outcome not reported in a usable way (Mehanna 2017: nodal recurrence 3 vs 1; distant metastases 21 vs 23).
1 study
GRADE not reported

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Total mortality · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

PET-CT following chemoradiotherapy (neck dissection only if… showed no clear difference in total mortality compared with planned neck dissection before or after chemoradiotherapy (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
3 years
HR 0.92 [0.65, 1.31]
1 study · 564 participants
Moderate

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Locoregional recurrence · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

PET-CT following chemoradiotherapy (neck dissection only if… showed no clear difference in locoregional recurrence compared with planned neck dissection before or after chemoradiotherapy (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
3 years
HR 1.00 [0.94, 1.06]
1 study · 564 participants
Moderate

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Adverse events associated with treatment · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

1 finding from 1 review

Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
Adverse events: 22 surgical complications in the PET-CT group vs 83 in the planned-surgery group (Mehanna 2017).
1 study · 564 participants
Very low

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

Disease-free survival · Adults with oral cavity or oropharyngeal cancer with nodal disease (stage N2 or N3)

1 finding from 1 review

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

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx

10 findings from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Mucositis (all grades)
Mucositis all grades: not estimable due to high heterogeneity (P=0.0009; I2=86%) between subgroups (cetuximab; nimotuzumab) and within cetuximab (I2=93%); 1417 participants, 3 studies. Table 3, row 1.6 (Ang 2014;…
3 studies · 1417 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Skin toxicity/acneiform rash (cetuximab, all grades)
RR 6.56 [5.35, 8.03]
2 studies · 1311 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Xerostomia (grades >=3)
RR 1.36 [0.80, 2.31]
2 studies · 1311 participants
GRADE not reported

Show 7 more findings

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Skin toxicity/acneiform rash (nimotuzumab, grades >=3)
RR 0.20 [0.01, 4.05]
1 study · 92 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Skin toxicity/acneiform rash (nimotuzumab, all grades)
RR 1.06 [0.85, 1.31]
1 study · 92 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Dysphagia (all grades)
RR 0.97 [0.92, 1.03]
3 studies · 1403 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Skin toxicity/acneiform rash (cetuximab, grades >=3)
RR 17.72 [8.33, 37.73]
3 studies · 1403 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Dysphagia (grades >=3)
RR 0.93 [0.83, 1.04]
3 studies · 1403 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Mucositis (grades >=3)
RR 1.20 [0.96, 1.51]
4 studies · 1495 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Xerostomia (all grades)
RR 0.97 [0.91, 1.04]
3 studies · 1417 participants
GRADE not reported

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Progression‐free survival · People with squamous cell carcinoma of the oral cavity or oropharynx

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard… showed no clear difference in progression-free survival compared with standard therapy alone (radiotherapy or chemoradiotherapy); GRADE not reported.

2 findings from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Monoclonal antibody + chemoradiotherapy vs chemoradiotherapy alone
HR 1.08 [0.89, 1.32]
1 study · 891 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Monoclonal antibody + radiotherapy vs radiotherapy alone
HR 0.70 [0.54, 0.91]
1 study · 424 participants
GRADE not reported

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Participant satisfaction · People with squamous cell carcinoma of the oral cavity or oropharynx

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
No included studies addressed participant satisfaction (review-wide gap).
0 studies
No studies found

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Costs (direct and indirect) · People with squamous cell carcinoma of the oral cavity or oropharynx

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
No included studies addressed direct and indirect costs to participants and health services (review-wide gap).
0 studies
No studies found

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Overall survival · People with squamous cell carcinoma of the oral cavity or oropharynx

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard… probably leads to lower overall survival compared with standard therapy alone (radiotherapy or chemoradiotherapy) (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
HR 0.82 [0.69, 0.97]
3 studies · 1421 participants
Moderate

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Locoregional control · People with squamous cell carcinoma of the oral cavity or oropharynx

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard… probably leads to lower locoregional control compared with standard therapy alone (radiotherapy or chemoradiotherapy) (moderate certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
HR 0.68 [0.52, 0.89]
1 study · 424 participants
Moderate

EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Quality of life · People with squamous cell carcinoma of the oral cavity or oropharynx

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months
Only one study (Bonner 2006, 424 participants) comprehensively assessed quality of life using EORTC QLQ-C30 (v3.0) and QLQ-H&N35; no statistically significant difference between groups for global health status or any…
1 study · 424 participants
GRADE not reported