What do systematic reviews say?

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

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Induction cisplatin+5-FU+docetaxel vs cisplatin+5-FU: disease-free survival HR 0.72 (95% CI 0.57 to 0.91, P = 0.006; Vermorken 2007). Prior to concurrent chemoradiation: Posner 2007 HR 0.71 (0.56 to 0.90, P = 0.005).…
  2 studies
  GRADE not reported

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

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Eight of 11 induction-before-radiotherapy studies reported overall survival; not pooled (heterogeneity). Only Vermorken 2007 significant: cisplatin+5-FU+docetaxel induction HR 0.73 (95% CI 0.57 to 0.93, P = 0.01).…
  8 studies
  GRADE not reported

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

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Locoregional control reported in 12 studies; not pooled. Olasz 2000 RR 0.50 (0.26 to 0.96); Prevost 2005 RR 1.48 (1.04 to 2.11); Molinari 1982 RR 0.35 (0.19 to 0.66).
  12 studies
  GRADE not reported

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

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Harms/toxicity were planned but very little quantitative data suitable for analysis were found; toxicity reported narratively and not quantified or GRADE-rated.
  Studies not reported
  GRADE not reported

Chemotherapy vs Placebo

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Types of studies: it was anticipated that there would be no studies comparing chemotherapy with placebo (none were identified).
  0 studies
  No studies found

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

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).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.95 [0.73, 1.22]
  5 studies · 353 participants
  Moderate

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

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  Quality of life was a planned (protocol) outcome but no included trial provided usable quality-of-life data; the protocol was modified to report only survival/response outcomes.
  0 studies
  No studies found

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

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.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.84 [0.72, 0.97]
  4 studies
  GRADE not reported

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

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).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.84 [0.72, 0.98]
  4 studies · 1097 participants
  Moderate

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction cisplatin + 5-fluorouracil + docetaxel… compared with locoregional treatment (radiotherapy and/or surgery) alone (low certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 1.08 [0.80, 1.44]
  3 studies · 760 participants
  Low

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Induction chemotherapy plus locoregional treatment (radiotherapy… led to lower locoregional control, induction cisplatin + 5-fluorouracil +… compared with locoregional treatment (radiotherapy and/or surgery) alone; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  RR 0.80 [0.64, 0.99]
  3 studies
  GRADE not reported

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction platinum + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone (low certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 1.06 [0.71, 1.60]
  1 study · 198 participants
  Low

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Induction chemotherapy plus locoregional treatment (radiotherapy… showed no clear difference in overall survival, induction platinum + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.85 [0.70, 1.04]
  5 studies · 7427 participants
  Moderate

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

Induction chemotherapy plus locoregional treatment (radiotherapy… led to lower disease-free survival, induction platinum + 5-fluorouracil prior to… compared with locoregional treatment (radiotherapy and/or surgery) alone; GRADE not reported.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.78 [0.63, 0.97]
  3 studies · 332 participants
  GRADE not reported

Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone

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).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.71 [0.37, 1.35]
  2 studies · 389 participants
  Low

Altered fractionation radiotherapy plus chemotherapy vs Chemoradiotherapy with standard (conventional) fractionation

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy 2010 · Cochrane All outcomes
  Discussion: 'there are no completed trials of altered fractionation plus chemotherapy versus chemoradiotherapy with standard fractionation.'
  0 studies
  No studies found

Surgery plus radiotherapy vs Chemotherapy (chemoradiotherapy)

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  oral cavity
  Disease-free survival: not reported (Iyer 2015).
  0 studies
  No studies found

Surgery plus radiotherapy vs Chemotherapy (chemoradiotherapy)

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  oral cavity
  Total mortality: study reported survival significantly better with surgery and RT vs chemoradiotherapy, but no useable data; 32 participants (1 RCT, Iyer 2015 oral cavity subgroup).
  1 study · 32 participants
  Very low

Surgery plus radiotherapy vs Chemotherapy (chemoradiotherapy)

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Adverse events: not reported for any participants (Iyer 2015).
  0 studies
  No studies found

Surgery plus radiotherapy vs Chemotherapy (chemoradiotherapy)

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  oral cavity
  Recurrence: not reported for the oral cancer subgroup (Iyer 2015).
  0 studies
  No studies found