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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
1,325 questions in 34 reviews · Oral medicine and oral cancer
current versionsNo studies 164 · 12.4%Ungraded 841 · 63.5%Very low 209 · 15.8%Low 72 · 5.4%Moderate 38 · 2.9%High 1 · 0.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs Placebo Number of days unable to take medicine orally · Adults with cancer receiving treatment Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | No studies reported this outcome (planned secondary outcome not measured by any study in the review) | 0 studies | No studies |
Amifostine vs No treatment/placebo Salivary flow rate (mg/5 min, unstimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · 12 months postRT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | MD 0.32 [0.09, 0.55] | 1 study · 27 participants | Very low |
Amifostine vs No treatment/placebo Progression-free survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · 12 to 24 months postRT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | HR 0.94 [0.70, 1.27] | 2 studies · 247 participants | Ungraded |
Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs Placebo Adverse events · Adults with cancer receiving treatment Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | Adverse events attributed to KGF were typically oral-related or skin-related; mostly mild to moderate with very few serious events; reporting poor and inconsistent, not appropriate to meta-analyse (SoF comments cell,… | 16 studies | Ungraded |
Granulocyte-colony stimulating factor (G-CSF; pegfilgrastim, single dose) vs Granulocyte-colony stimulating factor (G-CSF; filgrastim, multiple doses) Oral mucositis (any severity) · Children receiving bone marrow/stem cell transplantation after conditioning therapy for mixed cancers · Children Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 1.02 [0.82, 1.27] | 1 study · 61 participants | Ungraded |
Biperiden plus pilocarpine vs No treatment Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | Survival not reported. | 0 studies | No studies |
Palifermin vs Placebo Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | None of the trials evaluating palifermin provided data on salivary flow rates. | 0 studies | No studies |
Epidermal growth factor (EGF), oral spray vs Placebo Oral mucositis (moderate to severe) · Adults with cancer receiving treatment · Chemoradiotherapy to the head and neck Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 1.06 [0.78, 1.43] | 1 study · 136 participants | Ungraded |
Keratinocyte growth factor (KGF), intravenous vs Chlorhexidine mouthwash Oral mucositis (any severity) · Children with acute lymphoblastic leukaemia receiving chemotherapy alone · Children Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 0.67 [0.54, 0.85] | 1 study · 90 participants | Ungraded |
Amifostine vs No treatment/placebo Dysgeusia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · End of RT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 0.24 [0.10, 0.61] | 1 study · 28 participants | Ungraded |
Zinc supplements vs Acupuncture Outcome NR · Patients with taste disturbances (dysgeusia/hypogeusia; idiopathic, zinc-deficient, or secondary to chronic renal… Interventions for managing taste disturbances (2017) · Cochrane | Authors' conclusions: We were unable to draw any conclusions regarding the superiority of zinc supplements or acupuncture as none of the trials compared these interventions. | 0 studies | No studies |
Granulocyte-colony stimulating factor (G-CSF; pegfilgrastim, single dose) vs Granulocyte-colony stimulating factor (G-CSF; filgrastim, multiple doses) Normalcy of diet (total parenteral nutrition) · Children receiving bone marrow/stem cell transplantation after conditioning therapy for mixed cancers · Children Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 1.00 [0.94, 1.06] | 1 study · 61 participants | Ungraded |
Selenium vs No intervention Xerostomia · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · 6 weeks after end of RT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No evidence that selenium reduced xerostomia; data unusable (bar charts with no standard deviations) (Buntzel 2010) | 1 study | Ungraded |
Palifermin vs Placebo Overall survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · 42 to 72 months from baseline Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | HR 1.00 [0.72, 1.39] | 3 studies | Moderate |
Granulocyte-colony stimulating factor (G-CSF) vs Placebo or no treatment Oral mucositis (severe) · Adults with cancer receiving treatment · RT to head and neck Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 0.37 [0.15, 0.87] | 2 studies · 54 participants | Low |
Antiseptic mouthrinse vs Placebo Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | Salivary flow rate was only reported during radiotherapy (i.e. not at any of the time points of interest); no usable data (Lanzos 2010) | 1 study | Ungraded |
Erythropoietin mouthwash vs Placebo Oral mucositis (moderate to severe) · Adults receiving bone marrow/stem cell transplantation after conditioning therapy for haematological cancers Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 0.43 [0.24, 0.79] | 1 study · 80 participants | Ungraded |
Pilocarpine vs No treatment/placebo Salivary flow rate (unstimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · Up to and including 3 months postRT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | MD -0.06 [-0.23, 0.11] | 1 study · 24 participants | Very low |
Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly Survival (overall survival and locoregional control) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | Insufficient evidence reported on overall survival or locoregional tumour control (Analysis 4.2; 4.3) | 1 study | Ungraded |
Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs Placebo Quality of life · Adults with cancer receiving treatment Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | No studies reported this outcome (planned secondary outcome not measured by any study in the review) | 0 studies | No studies |
Biperiden plus pilocarpine vs No treatment Side effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No data were reported on side effects. | 0 studies | No studies |
Amifostine (intravenous) vs Amifostine (subcutaneous) Locoregional tumour control · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · 48 months postRT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | HR 1.34 [0.76, 2.36] | 1 study | Ungraded |
Bethanechol vs Placebo Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No survival data were reported. | 0 studies | No studies |
Amifostine vs No treatment/placebo Cost (mean per-patient supportive care costs) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · End of RT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | Mean per-patient supportive care costs lower with amifostine (USD 4401) than control (USD 5873); P = 0.02 (Buntzel 1998 / Bennett 2001) | 1 study · 28 participants | Ungraded |
Pilocarpine vs No treatment/placebo Xerostomia (objective, LENT-SOMA scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · 6 months postRT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | MD -0.40 [-0.69, -0.11] | 1 study · 39 participants | Ungraded |
Zinc supplements (zinc sulphate, zinc gluconate, zinc picolinate, zinc acetate, or polaprezinc) vs Placebo Taste acuity improvement - objective outcome (continuous) - individual taste sensations · Patients with taste disturbances (dysgeusia/hypogeusia; idiopathic, zinc-deficient, or secondary to chronic renal… · Chronic renal failure Interventions for managing taste disturbances (2017) · Cochrane | Results (Mahajan 1980, chronic renal failure; Analysis 1.3): mean difference by taste sensation - salt MD 285 (95% CI 238.75 to 331.25); sweet MD 190 (142.36 to 237.64); sour MD 10 (-16.43 to 36.43); bitter MD 2.40… | 1 study · 22 participants | Ungraded |
Amifostine (intravenous) vs Amifostine (subcutaneous) Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No salivary flow rate data related to routes of administration of amifostine were reported. | 0 studies | No studies |
Amifostine vs No treatment/placebo Adverse effects (other reported events) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | Alopecia, skin toxicity, hot flush, drowsiness, sneezing, hiccupping, dizziness and fatigue reported narratively or only for the amifostine group; insufficient evidence of a difference | NR | Ungraded |
Amifostine vs No treatment/placebo Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · End of RT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 0.35 [0.19, 0.67] | 3 studies · 119 participants | Low |
Amifostine vs No treatment/placebo Allergic response (adverse effect) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 7.51 [1.40, 40.39] | 3 studies · 524 participants | Low |
Granulocyte-colony stimulating factor (G-CSF) vs Placebo or no treatment Adverse events · Adults with cancer receiving treatment Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | Limited evidence of adverse events for G-CSF; 2 of 6 studies did not report; low rates of mild to moderate events, most commonly bone pain (SoF comments cell, not GRADE-rated) | 6 studies | Ungraded |
Polaprezinc vs Azulene oral rinse Taste disturbance (severe, > 2 on 0-3 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · Over RT period Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 0.12 [0.02, 0.83] | 1 study · 31 participants | Ungraded |
Palifermin vs Placebo Adverse effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No evidence of a difference in reported adverse events across the three trials (nausea, fever, constipation, diarrhoea, headache, fatigue and others) | 3 studies | Ungraded |
Granulocyte-macrophage colony-stimulating factor (GM-CSF), mouthwash vs Sucralfate mouthwash Normalcy of diet (percutaneous endoscopic gastrostomy) · Adults receiving radiotherapy to the head and neck · RT to head and neck Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 0.18 [0.01, 3.56] | 1 study · 40 participants | Ungraded |
Bethanechol vs Artificial saliva Xerostomia (dry mouth, yes/no) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · End of RT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 0.63 [0.30, 1.29] | 1 study · 36 participants | Ungraded |
Chinese medicine vs No treatment/placebo Xerostomia (VAS) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · End of RT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | Difference in favour of Chinese medicine on VAS xerostomia (P < 0.05); standard deviations not available (Wang 1998) | 1 study · 50 participants | Ungraded |
Granulocyte-colony stimulating factor (G-CSF) vs Placebo or no treatment Oral mucositis (any severity) · Adults with cancer receiving treatment · Chemotherapy alone for lung cancer Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 0.59 [0.40, 0.87] | 1 study · 195 participants | Ungraded |
Antimicrobial lozenge vs Placebo Xerostomia · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · Up to and including 3 months postRT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 1.16 [0.97, 1.40] | 1 study · 133 participants | Ungraded |
Antiseptic mouthrinse vs Placebo Quality of life · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No quality of life data were reported. | 0 studies | No studies |
Selenium vs No intervention Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No survival data were reported. | 0 studies | No studies |
Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs Placebo Oral mucositis (moderate to severe) · Adults with cancer receiving treatment · BMT/SCT after conditioning for haematological cancers Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 0.89 [0.80, 0.99] | 6 studies · 852 participants | Low |
Polaprezinc vs Azulene oral rinse Xerostomia (severe) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · End of RT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 0.17 [0.04, 0.65] | 1 study · 31 participants | Ungraded |
Amifostine vs No treatment/placebo Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · 12 months postRT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 0.70 [0.40, 1.23] | 7 studies · 682 participants | Low |
Chinese medicine vs No treatment/placebo Xerostomia (dichotomous, Shenqi Fanghou recipe) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region · End of RT Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 0.39 [0.28, 0.55] | 1 study · 140 participants | Ungraded |
Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs Placebo Oral pain (mean worst pain, 0 to 10 scale) · Adults with cancer receiving treatment · BMT/SCT after conditioning for haematological cancers Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | MD -0.85 [-3.00, 1.30] | 1 study · 42 participants | Ungraded |
Amifostine (intravenous) vs Amifostine (subcutaneous) Adverse effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | Increased hypotension with intravenous delivery (20% vs 8%; P = 0.007); skin rash (10% vs 22%; P = 0.012) and local pain at injection site (0% vs 8%; P = 0.001) worse with subcutaneous; inconclusive for… | 1 study | Ungraded |
Granulocyte-colony stimulating factor (G-CSF) vs Placebo or no treatment Oral mucositis (any severity) · Adults with cancer receiving treatment · RT to head and neck Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and… (2017) · Cochrane | RR 1.02 [0.86, 1.22] | 2 studies · 54 participants | Ungraded |
Bethanechol vs Placebo Quality of life · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No data on either quality of life or other oral related symptoms were reported. | 0 studies | No studies |
Amifostine vs No treatment/placebo Vomiting (adverse effect) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | RR 4.90 [2.87, 8.38] | 5 studies · 601 participants | Low |
Zinc supplements (zinc sulphate, zinc gluconate, zinc picolinate, zinc acetate, or polaprezinc) vs Placebo Taste acuity improvement - objective outcome (continuous) - taste detection (cross-over trial) · Patients with taste disturbances (dysgeusia/hypogeusia; idiopathic, zinc-deficient, or secondary to chronic renal… · 6 months, Children with chronic renal failure Interventions for managing taste disturbances (2017) · Cochrane | MD 2.50 [0.93, 4.07] | 1 study · 14 participants | Very low |