立体定向放射外科 (SRS) 是治疗数量有限的小脑转移瘤患者的主要治疗方法。头部固定通常采用基于框架（FB）的固定；然而，基于面罩（MB）的固定已成为一种侵入性较小的替代方案。尚未对两种方法进行比较荟萃分析。截至 2023 年 8 月 28 日，我们检索了数据库，以识别比较 MB 和 FB SRS 在脑转移治疗中的研究。我们感兴趣的结果包括局部肿瘤控制（LTC）、放射性坏死（RN）、死亡率和治疗时间（TT）。采用平均差（MD）、风险比（RR）和风险比（HR）进行统计比较。从最初确定的295篇文章中，纳入了涉及509名患者的6项研究（1项临床试验）。 LTC 显示 6 个月时的 RR (RR = 0.95[95%CI = 0.89-1.01]，p = 0.12) 和 FB SRS 的 1 年时的边际效益 (RR = 0.87[95%CI = 0.78-0.96] ，p = 0.005）。然而，在仅用单次 SRS 治疗的寡转移中，组间 LTC 相似（RR = 0.92 [95%CI = 0.89-1.0]，p = 0.30）。同样，在接受单次 SRS 治疗的寡转移患者中，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），组间死亡率相似（RR = 0.62；95%CI = 0.22-1.76，p = 0.37）。我们的研究结果表明，FB 和 MB SRS，特别是单次治疗的寡转移，在 LTC 方面具有可比性、RN、TT 和死亡率。进一步的研究对于得出明确的结论至关重要。© 2024。作者获得 Springer Science Business Media, LLC（Springer Nature 旗下公司）的独家许可。

Stereotactic 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.Databases 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.From 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).Our 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.© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.