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

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

It is very uncertain whether oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed… changes oral mucositis (any severity) compared with low-dose leucovorin rinse (very low certainty).

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
  RR 0.67 [0.50, 0.90]
  1 study · 118 participants
  Very low

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

It is very uncertain whether oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed… changes oral mucositis (moderate to severe) compared with low-dose leucovorin rinse (very low certainty).

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
  RR 0.18 [0.01, 3.42]
  1 study · 118 participants
  Very low

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

It is very uncertain whether oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed… changes oral mucositis (any severity) compared with high-dose leucovorin rinse (very low certainty).

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
  RR 0.65 [0.47, 0.90]
  1 study · 81 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

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

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
  Oral mucositis (moderate to severe). Not estimable - no participants had developed moderate or severe oral mucositis by the fourth day after chemotherapy when the data were reported (Zhang 2011, Analysis 4.2, subgroup…
  1 study · 81 participants
  GRADE not reported

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

Sulodexide (heparin plus dermatan sulphate chains) vs prednisone

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  A comparison between sulodexide (n=10) and prednisone (n=10) was made in a trial at high risk of bias (Femiano 2003). Data presented as ranges/totals only with no estimate of variability, precluding further analysis.…
  1 study · 20 participants
  GRADE not reported

Colchicine (0.5 mg per day for 3 months) vs prednisolone

Colchicine (0.5 mg per day for 3 months) showed no clear difference in pain at completion of treatment compared with prednisolone (5 mg per day for 3 months); GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  3 months
  MD -0.16 [-1.18, 0.86]
  1 study · 34 participants
  GRADE not reported

Sulodexide (heparin plus dermatan sulphate chains) vs prednisone

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  Sulodexide was without significant adverse events; one significant adverse event (gastritis) was reported for the prednisone group.
  1 study · 20 participants
  GRADE not reported

Colchicine (0.5 mg per day for 3 months) vs prednisolone

Colchicine (0.5 mg per day for 3 months) showed no clear difference in number of aphthous ulcers at completion compared with prednisolone (5 mg per day for 3 months); GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  3 months
  MD -0.13 [-0.50, 0.24]
  1 study · 34 participants
  GRADE not reported

Colchicine (0.5 mg per day for 3 months) vs prednisolone

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  3 months
  Colchicine was associated with statistically significantly more adverse effects than prednisolone (nine participants reporting adverse effects on colchicine versus two on prednisolone).
  1 study · 34 participants
  GRADE not reported

Colchicine (0.5 mg per day for 3 months) vs prednisolone

Colchicine (0.5 mg per day for 3 months) showed no clear difference in recurrence during treatment period compared with prednisolone (5 mg per day for 3 months); GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  3 months
  RR 1.30 [0.98, 1.71]
  1 study · 34 participants
  GRADE not reported

Low‐level laser therapy vs Povidone

Laser (low level) led to lower oral mucositis (moderate to severe) compared with povidone; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.29 [0.16, 0.54]
  1 study · 50 participants
  GRADE not reported

Low‐level laser therapy vs Povidone

Laser (low level) led to lower oral mucositis (severe) compared with povidone; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.02 [0, 0.31]
  1 study · 50 participants
  GRADE not reported

Human placental extract vs Disprin (aspirin/betamethasone)

Human placental extract led to higher improvement in mucositis compared with disprin (aspirin/betamethasone); GRADE not reported.

• Interventions for treating oral mucositis for patients with cancer receiving treatment 2010 · Cochrane All outcomes
  RR 4.50 [2.29, 8.86]
  1 study · 120 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