Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,106 questions · 1,202 findings · 24 reviews · Oral medicine and oral cancer

No studies found 145 · 12.1%GRADE not reported 760 · 63.2%Very low 201 · 16.7%Low 66 · 5.5%Moderate 29 · 2.4%High 1 · 0.1%

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

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

Toxicity / adverse effects (harms) of chemotherapy · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer
1 finding from 1 review

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Disease-free survival · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

Concomitant (concurrent) chemoradiotherapy led to lower disease-free survival, concurrent chemoradiotherapy vs radiotherapy… compared with radiotherapy alone (non-resectable tumours); GRADE not reported.

1 finding from 1 review

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

Disease-free survival · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

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.

1 finding from 1 review

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

Overall survival, adjuvant concomitant chemoradiotherapy vs post-surgery radiotherapy alone · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

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).

1 finding from 1 review

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

Chemotherapy regimen A (+/- locoregional treatment) vs Chemotherapy regimen B (+/- locoregional treatment)

Locoregional control · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer
1 finding from 1 review

Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone

Overall survival, adjuvant concomitant chemoradiotherapy vs post-surgery radiotherapy alone · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer

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

1 finding from 1 review

Topical triamcinolone acetonide vs pimecrolimus 1%

Adverse effects · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical triamcinolone acetonide showed no clear difference in adverse effects compared with topical pimecrolimus; GRADE not reported.

1 finding from 1 review

Clobetasol propionate plus miconazole (adjunctive antifungal) vs Clobetasol propionate plus placebo

Candidosis (adverse effect) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment
1 finding from 1 review

Topical clobetasol propionate vs Topical ciclosporin

Pain resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

It is very uncertain whether topical clobetasol propionate changes pain resolution compared with topical ciclosporin (very low certainty).

1 finding from 1 review

Topical clobetasol propionate vs Topical tacrolimus

Pain (mean VAS score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical clobetasol propionate showed no clear difference in pain (mean VAS score) compared with topical tacrolimus; GRADE not reported.

1 finding from 1 review

Topical clobetasol propionate vs Topical tacrolimus

Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

It is very uncertain whether topical clobetasol propionate changes clinical resolution compared with topical tacrolimus (very low certainty).

1 finding from 1 review

Oral prednisone plus curcuminoids (adjunctive) vs Oral prednisone plus placebo

Reduction in pain · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment
1 finding from 1 review

Topical triamcinolone acetonide vs Intralesional BCG-polysaccharide nucleic acid (BCG-PSN)

Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical triamcinolone acetonide showed no clear difference in pain (mean score) compared with intralesional BCG-polysaccharide nucleic acid (BCG-PSN); GRADE not reported.

1 finding from 1 review

Systemic (oral) betamethasone vs Topical triamcinolone acetonide paste

Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

It is very uncertain whether systemic (oral) betamethasone changes clinical score compared with topical triamcinolone acetonide paste (very low certainty).

1 finding from 1 review