Findings

What do systematic reviews say?

195 questions · 226 findings · 16 reviews · Oral medicine and oral cancer

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No studies found 18 · 8%GRADE not reported 143 · 63.3%Very low 45 · 19.9%Low 14 · 6.2%Moderate 6 · 2.7%High 0 · 0%

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

Granulocyte-colony stimulating factor (G-CSF; pegfilgrastim, single dose) vs Granulocyte-colony stimulating factor (G-CSF; filgrastim, multiple doses)

Oral mucositis (moderate to severe) · Children receiving bone marrow/stem cell transplantation after conditioning therapy for mixed cancers

Granulocyte-colony stimulating factor (G-CSF; pegfilgrastim, single… showed no clear difference in oral mucositis (moderate to severe) compared with granulocyte-colony stimulating factor (G-CSF; filgrastim, multiple…; 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 0.78 [0.55, 1.11]
1 study · 61 participants
GRADE not reported

Granulocyte-macrophage colony-stimulating factor (GM-CSF), higher dose (1260 to 12,600 micrograms) vs Granulocyte-macrophage colony-stimulating factor (GM-CSF), lower dose (12.6 to 126 micrograms)

Oral mucositis (severe) · breast cancer patients undergoing chemotherapy

Granulocyte-macrophage colony-stimulating factor (GM-CSF), higher… led to higher oral mucositis (severe) compared with granulocyte-macrophage colony-stimulating factor (GM-CSF), lower…; 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
RR 2.75 [1.07, 7.04]
1 study · 36 participants
GRADE not reported

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

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

Keratinocyte growth factor (KGF), intravenous led to lower oral mucositis (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 0.01 [0.00, 0.19]
1 study · 90 participants
GRADE not reported

Intestinal trefoil factor (ITF), lower dose (336 mg) vs Intestinal trefoil factor (ITF), higher dose (2688 mg)

Oral mucositis (any severity) · Adults receiving chemotherapy alone for colorectal cancer

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Insufficient evidence to determine whether lower (336 mg) or higher (2688 mg) dose performs better (Analyses 11.1 to 11.3); no pooled estimate reported
1 study · 66 participants
GRADE not reported

Erythropoietin mouthwash vs placebo

Oral mucositis (any severity) · Adults receiving bone marrow/stem cell transplantation after conditioning therapy for haematological cancers

Erythropoietin mouthwash led to lower oral mucositis (any severity) 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
RR 0.35 [0.21, 0.60]
1 study · 80 participants
GRADE not reported

Erythropoietin mouthwash vs placebo

Number of days in hospital · Adults receiving bone marrow/stem cell transplantation after conditioning therapy for haematological cancers

Erythropoietin mouthwash showed no clear difference in number of days in hospital 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
MD -2.95 [-7.73, 1.83]
1 study · 80 participants
GRADE not reported

Intestinal trefoil factor (ITF), oral spray vs placebo

Oral mucositis (severe) · Adults receiving chemotherapy alone for colorectal cancer

Intestinal trefoil factor (ITF), oral spray showed no clear difference in oral mucositis (severe) 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
RR 1.52 [0.06, 36.39]
1 study · 99 participants
GRADE not reported

Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone (radiotherapy or chemoradiotherapy)

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

Non-specific immunotherapy (recombinant interleukin-2 or BCG cell… showed no clear difference in adverse effects compared with standard therapy alone; GRADE not reported.

9 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 · Moderate to severe chills (BCG-CWP, all grades)
RR 11.00 [0.67, 179.29]
1 study · 24 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 · Nausea/vomiting (rIL-2, grades >=3)
RR 3.40 [0.15, 77.34]
1 study · 30 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 · Stomatitis (rIL-2, all grades)
RR 1.47 [0.75, 2.90]
1 study · 30 participants
GRADE not reported

Show 6 more findings

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
24 to 70 months · Leukopenia (rIL-2, all grades)
RR 0.57 [0.22, 1.50]
1 study · 30 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 · Increased temperature (BCG-CWP, all grades)
RR 0.67 [0.13, 3.30]
1 study · 24 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 · Leukopenia (rIL-2, grades >=3)
RR 0.38 [0.04, 3.26]
1 study · 30 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 · Nausea/vomiting (rIL-2, all grades)
RR 1.24 [0.90, 1.70]
1 study · 30 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 · Stomatitis (rIL-2, grades >=3)
RR 1.71 [0.33, 8.83]
1 study · 30 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 · Gastrointestinal complaints (BCG-CWP, all grades)
RR 5.00 [0.27, 94.34]
1 study · 24 participants
GRADE not reported

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) 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

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… led to higher adverse effects compared with standard therapy alone (radiotherapy or chemoradiotherapy); GRADE not reported.

9 findings from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Skin toxicity (lapatinib, all grades)
RR 2.02 [1.23, 3.32]
1 study · 67 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Gastrointestinal complaints (gefitinib, all grades)
RR 1.04 [0.98, 1.11]
1 study · 226 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Gastrointestinal complaints (lapatinib, all grades)
RR 15.53 [2.18, 110.55]
1 study · 67 participants
GRADE not reported

Show 6 more findings

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Skin toxicity (erlotinib, all grades)
RR 6.57 [3.60, 12.00]
1 study · 191 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Mucositis (grades >=3)
RR 1.22 [0.96, 1.56]
2 studies · 286 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Mucositis (all grades)
RR 1.03 [0.94, 1.11]
2 studies · 286 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Skin toxicity (gefitinib, all grades)
RR 1.03 [0.82, 1.28]
2 studies · 286 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Gastrointestinal complaints (grades >=3, pooled)
RR 1.11 [0.83, 1.49]
3 studies · 484 participants
GRADE not reported
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months · Skin toxicity (grades >=3, pooled)
RR 1.25 [0.54, 2.88]
4 studies · 544 participants
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

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs High-dose leucovorin rinse

Oral mucositis (severe) · Patients with osteosarcoma (bone cancer) receiving high-dose methotrexate, vincristine and leucovorin

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
Oral mucositis (severe). Not estimable - no participants had developed severe oral mucositis by the fourth day after chemotherapy when the data were reported (Zhang 2011, Analysis 4.3, subgroup 3.2); 81 participants in…
1 study · 81 participants
GRADE not reported

Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Disease-free survival · People with squamous cell carcinoma of the oral cavity or oropharynx

It is very uncertain whether non-specific immunotherapy (recombinant interleukin-2 or BCG cell… changes disease-free survival compared with standard therapy alone (very low 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 · Recombinant interleukin-2 + surgery (De Stefani 2002)
HR 0.66 [0.43, 1.02]
1 study · 201 participants
Very low

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

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Low-dose leucovorin rinse

Oral mucositis (severe) · Patients with osteosarcoma (bone cancer) receiving high-dose methotrexate, vincristine and leucovorin

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
Oral mucositis (severe). Not estimable - no participants had developed severe oral mucositis by the fourth day after chemotherapy when the data were reported (Zhang 2011, Analysis 4.3, subgroup 3.1); 118 participants…
1 study · 118 participants
GRADE not reported

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) 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

It is very uncertain whether tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… changes progression-free survival compared with standard therapy alone (radiotherapy or chemoradiotherapy) (very low certainty).

1 finding from 1 review

Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes
40 to 60 months
HR 0.80 [0.51, 1.28]
2 studies · 271 participants
Very low

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

Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone (radiotherapy or chemoradiotherapy)

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

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 · BCG cell wall preparation + surgery (Bier 1981)
BCG-CWP + surgery versus surgery alone: 3-year overall survival 10/10 vs 9/10; too few participants to calculate a hazard ratio (Bier 1981, 24 participants).
1 study · 24 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 · Recombinant interleukin-2 + surgery (De Stefani 2002)
HR 0.52 [0.31, 0.87]
1 study · 201 participants
Very low