What do systematic reviews say?

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

Hyperfractionated radiotherapy vs Conventional (standard) fractionation radiotherapy

Hyperfractionated 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 0.74 [0.62, 0.89]
  3 studies · 966 participants
  GRADE not reported

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

Accelerated radiotherapy with concomitant boost showed no clear difference in total mortality 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 0.95 [0.80, 1.13]
  3 studies · 1203 participants
  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, disease free survival: all four trials provided data; pooled estimate showed a statistically significant difference in favour of the accelerated/boost schedule, with statistical…
  4 studies · 1203 participants
  GRADE not reported

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

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

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

  2 years
  RR 1.33 [0.67, 2.67]
  1 study · 110 participants
  GRADE not reported

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

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

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 1.13 [0.78, 1.64]
  1 study
  GRADE not reported

Hyperfractionated radiotherapy vs Conventional (standard) fractionation radiotherapy

Hyperfractionated radiotherapy led to lower total mortality 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 0.78 [0.68, 0.90]
  3 studies · 966 participants
  GRADE not reported

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

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

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

  2 years
  RR 0.83 [0.29, 2.42]
  1 study · 110 participants
  GRADE not reported

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

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

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 1.13 [0.78, 1.64]
  1 study
  GRADE not reported

Neutron radiotherapy vs Conventional photon radiotherapy

Neutron 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

  5 years
  RR 0.97 [0.69, 1.36]
  1 study
  GRADE not reported

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

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

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

  5 years · All included studies
  HR 0.86 [0.76, 0.98]
  13 studies · 3751 participants
  Very low
• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes

  5 years · Studies at low risk of bias (sensitivity analysis)
  HR 0.93 [0.80, 1.07]
  5 studies · 1511 participants
  Moderate

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

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Accelerated vs conventional, total mortality: only one trial reported data (Skladowski 2006; IPD available). A statistically significant difference in favour of the altered fractionation was shown (Analysis 1.1). No…
  1 study
  GRADE not reported

Hyperfractionated radiotherapy vs Conventional (standard) fractionation radiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Hyperfractionated vs conventional, disease free survival: data available for one trial (Fu 2000); no statistically significant difference (Analysis 1.3). No pooled estimate reported.
  1 study
  GRADE not reported

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

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.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 1.13 [0.78, 1.64]
  1 study
  GRADE not reported

Higher total dose radiotherapy (76.8 Gy over 6.4 weeks) vs conventional dose RT

Higher total dose radiotherapy (76.8 Gy over 6.4 weeks) showed no clear difference in total mortality compared with conventional/standard total dose radiotherapy (72 Gy); GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 1.08 [0.69, 1.70]
  1 study
  GRADE not reported

Hyperfractionated/accelerated/split-course radiotherapy vs Conventional (standard) fractionation radiotherapy

Hyperfractionated/accelerated/split-course radiotherapy showed no clear difference in total mortality 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 1.02 [0.90, 1.17]
  4 studies · 1299 participants
  GRADE not reported

Orthodontic treatment with appliances inducing stable, permanent orthodontic tooth movement (splints worn 8 to 12 weeks and surgical interventions excluded) vs Control: no treatment, placebo, or reassurance

The review found no eligible studies for this question.

• Orthodontics for treating temporomandibular joint (TMJ) disorders 2010 · Cochrane All outcomes

  At least 6 months after the intervention
  no estimate extracted
  0 studies
  No studies found

Radiotherapy (morning) vs Afternoon radiotherapy

Morning radiotherapy showed no clear difference in total mortality compared with afternoon radiotherapy; GRADE not reported.

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

  2 years
  RR 1.09 [0.74, 1.59]
  1 study · 216 participants
  GRADE not reported

Hyperfractionated/accelerated/split-course radiotherapy vs Conventional (standard) fractionation radiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Hyperfractionated/accelerated/split vs conventional, disease free survival: two trials (Fu 2000, Olmi 2003); results contradictory with substantial statistical heterogeneity (P = 0.02, I2 = 82%); no pooled estimate…
  2 studies
  GRADE not reported