Evidence map›Paper›PMID 39153030›Full record

SynthesisJournal of neuro-oncology2024

Comparative effectiveness of frame-based and mask-based Gamma Knife stereotactic radiosurgery in brain metastases: A 509 patient meta-analysis.

Pavel S Pichardo-Rojas, Diego Vázquez-Alva, José A Alvarez-Castro, Brandon Flores-Patiño, Enrique Escalante-Ordoñez, Julio A Haro-Adame, Carlos E Espinosa-Temaxte, Mark Amsbaugh, Angel I Blanco, Daniel M Trifiletti and 1 more

Abstract readMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Pavel S Pichardo-RojasThe Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA.
Diego Vázquez-AlvaFacultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico, México.
José A Alvarez-CastroInstituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, Mexico.
Brandon Flores-PatiñoUniversidad de Celaya, Guanajuato, México.
Enrique Escalante-OrdoñezFacultad de Ciencias de La Salud, Universidad Juárez del Estado de Durango, Durango, México.
Julio A Haro-AdameFacultad de Ciencias de La Salud, Universidad Autónoma de Baja California, Baja California, México.
Carlos E Espinosa-TemaxteFacultad de Medicina, Universidad Cristóbal Colón, Veracruz, México.
Mark AmsbaughThe Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA.
Angel I BlancoThe Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA.
Daniel M TrifilettiDepartment of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA.
Yoshua EsquenaziThe Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA. Yoshua.EsquenaziLevy@uth.tmc.edu.ORCID http://orcid.org/0000-0002-9757-1453

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeStereotactic Radiosurgery (SRS) is the primary treatment for patients with limited numbers of small brain metastases. Head fixation is usually performed with framed-based (FB) fixation; however, mask-based (MB) fixation has emerged as a less invasive alternative. A comparative meta-analysis between both approaches has not been performed.

methodsDatabases were searched until August 28th, 2023, to identify studies comparing MB and FB SRS in the treatment of brain metastases. Our outcomes of interest included local tumor control (LTC), radiation necrosis (RN), mortality, and treatment time (TT). Mean difference (MD), risk ratio (RR), and hazard ratio (HR) were used for statistical comparisons.

resultsFrom 295 articles initially identified, six studies (1 clinical trial) involving 509 patients were included. LTC revealed comparable RR at 6-months (RR = 0.95[95%CI = 0.89-1.01], p = 0.12) and a marginal benefit in FB SRS at 1-year (RR = 0.87[95%CI = 0.78-0.96], p = 0.005). However, in oligometastases exclusively treated with single-fraction SRS, LTC was similar among groups (RR = 0.92 [95%CI = 0.89-1.0], p = 0.30). Similarly, in patients with oligometastases treated with single-fraction SRS, 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 similar among groups (RR = 0.62; 95%CI = 0.22-1.76, p = 0.37).

conclusionOur findings suggest that FB and MB SRS, particularly oligometastases treated with single-fraction, are comparable in terms of LTC, RN, TT, and mortality. Further research is essential to draw definitive conclusions.

Indexed as

Brain NeoplasmsRadiosurgeryHumansTreatment OutcomeFrame-basedLocal tumor controlMask-basedMetastatic brain tumorsRadiotherapy techniquesStereotactic radiosurgeryTreatment efficacy

Identifiers

PMID39153030

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.