What do systematic reviews say?

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

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

• Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes

  40 to 60 months
  HR 0.99 [0.62, 1.57]
  2 studies · 271 participants
  Very low

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

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

• Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes

  40 to 60 months · Gefitinib + radiotherapy (oral cavity)
  HR 1.51 [0.61, 3.71]
  1 study · 60 participants
  Very low

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

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

• Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes

  40 to 60 months
  HR 0.89 [0.53, 1.49]
  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)

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

• 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

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

• Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy 2015 · Cochrane All outcomes

  24 to 70 months · Recombinant interleukin-2 + neoadjuvant chemotherapy (Mantovani 1998), tumour response
  Response to treatment (Mantovani 1998; neoadjuvant chemotherapy + rIL-2 vs chemotherapy alone): complete response 4/13 vs 3/15; partial response 6/13 vs 9/15. Narrative only; no GRADE rating.
  1 study · 33 participants
  GRADE not reported

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

• 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

Betamethasone oral mini-pulse therapy vs Topical triamcinolone acetonide paste

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  Table 3 (Side-effects). Malhotra 2008: betamethasone oral mini-pulse - transient oedema over the face (7), oedema over hands and feet (4), epigastric discomfort (7), weakness/fatigue (5), loose stools (1), headache…
  1 study · 22 participants
  GRADE not reported

Betamethasone oral mini-pulse therapy vs Topical triamcinolone acetonide paste

Betamethasone oral mini-pulse therapy led to higher physician Global Assessment (clinical severity, 0-12 score) compared with topical triamcinolone acetonide 0.1% paste; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes

  24 weeks
  MD 1.78 [0.17, 3.39]
  1 study · 22 participants
  GRADE not reported

Mixed beam (neutron and photon) radiotherapy vs Conventional photon radiotherapy

Mixed beam (neutron and photon) 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
  HR 1.04 [0.84, 1.29]
  1 study · 327 participants
  GRADE not reported

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

Hyperfractionated/accelerated 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 0.84 [0.72, 0.99]
  4 studies · 1071 participants
  GRADE not reported
• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 0.79 [0.70, 0.89]
  11 studies
  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, locoregional control: IPD from one trial (Fu 2000); a statistically significant difference in favour of the accelerated schedule with boost was shown (Analysis 1.2). No numeric…
  1 study
  GRADE not reported

Low dose rate interstitial radiotherapy vs High dose rate interstitial radiotherapy

Low dose rate interstitial radiotherapy showed no clear difference in locoregional control compared with high dose rate interstitial radiotherapy; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  HR 1.00 [0.16, 6.44]
  1 study · 59 participants
  GRADE not reported

Hyperfractionated/accelerated split-course radiotherapy vs Accelerated radiotherapy with concomitant boost

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Hyperfractionated/accelerated split course vs accelerated boost (Fu 1995, feasibility study, 75 participants): authors report no significant difference in total mortality; data not presented in a way that allows…
  1 study · 75 participants
  GRADE not reported

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