KEY TAKEAWAYS
- The study aimed to compare framed-based and mask-based fixation in SRS for small BM.
- The results concluded that FB and MB SRS are comparable for single-fraction oligometastases, warranting further research.
Stereotactic radiosurgery (SRS) is the primary treatment for patients with limited small brain cancer metastases. Typically, head fixation is done using framed-based (FB) methods, but mask-based (MB) fixation has emerged as a less invasive alternative. A comparative meta-analysis of these two approaches has yet to be conducted.
Pavel S. Pichardo-Rojas and the team aimed to compare framed-based and MB fixation in stereotactic radiosurgery for treating small brain metastases (BM).
Researchers searched databases up to August 28, 2023, to identify studies comparing MB and FB SRS in treating brain metastases. The primary outcomes of interest included local tumor control (LTC), radiation necrosis (RN), mortality, and treatment time (TT). Statistical comparisons were made using mean difference (MD), risk ratio (RR), and HR.
From an initial 295 articles, 6 studies (including one clinical trial) involving 509 patients were included in the analysis. LTC showed a comparable RR at 6 months (RR = 0.95 [95% CI = 0.89–1.01], P= 0.12) and a slight advantage for FB SRS at one year (RR = 0.87 [95% CI = 0.78–0.96], P= 0.005).
However, in patients with oligometastases treated exclusively with single-fraction SRS, LTC was similar between the groups (RR = 0.92 [95% CI = 0.89–1.0], P= 0.30). Similarly, among these patients, RN (HR= 1.69; 95% CI = 0.72–3.97, P= 0.22), TT (MD = -29.64; 95% CI = -80.38–21.10, P= 0.25), and mortality were also comparable between the groups (RR = 0.62; 95% CI = 0.22–1.76, P= 0.37).
The findings suggest that FB and MB SRS are comparable in treating oligometastases, particularly with single-fraction treatment, across outcomes such as LTC, RN, TT, and mortality. Further research is needed to draw definitive conclusions.
No financial support was received,
Source: https://link.springer.com/article/10.1007/s11060-024-04738-8
Pichardo-Rojas PS, Vázquez-Alva D, Alvarez-Castro JA, et al. (2024). “Comparative effectiveness of frame-based and mask-based Gamma Knife stereotactic radiosurgery in brain metastases: A 509 patient meta-analysis.” J Neurooncol. 2024. doi:10.1007/s11060-024-04738-8
