NOTQ-06 HEMORRHAGIC RISK FOLLOWING STEREOTACTIC RADIOSURGERY FOR MELANOMA BRAIN METASTASES: A SYSTEMATIC REVIEW AND META-ANALYSIS

作者：Ruchit Jain, Khalid Qidwai, Zouina Sarfraz, Fatma Nikan Akkoc Mustafayev, Namita Ruhela, Manmeet Singh Ahluwalia · 发表于：Neuro-Oncology Advances · 年份：2026 · DOI：10.1093/noajnl/vdag161.055 · 研究领域：Brain Metastases and Treatment、Cutaneous Melanoma Detection and Management、Melanoma and MAPK Pathways

Abstract Background Melanoma brain metastases (MBM) have a well-recognized propensity for hemorrhage, raising concerns regarding the safety of stereotactic radiosurgery (SRS). However, the incidence and prognostic implications of post-SRS hemorrhage remain poorly defined. We performed a systematic review and meta-analysis to quantify hemorrhagic risk following SRS for MBM. Methods A systematic search of PubMed, Embase, and Scopus and Web of Science was conducted to identify studies reporting hemorrhagic outcomes following SRS for MBM. The primary outcome was post-SRS hemorrhage incidence. A random-effects model was used to pool proportions. Results Four retrospective studies comprising 659 patients and 3,035 lesions were included. The median age was 58 years (range: 53-60.4 years). The median dose prescribed was 21 Gy (range: 18-24). The KPS across the cohort was 90. The median tumor volume was 1.44 cc (range: 0.4-2.1). The median follow up was 8 months (range: 3.8-17.7). The pooled post-SRS hemorrhage rate was 27.3% (95% CI: 18.6–38.1), with substantial heterogeneity (I² = 76%). Importantly, two studies identified post-SRS hemorrhage as a significant adverse prognostic factor for overall survival (HR 1.55 and 1.39, respectively), suggesting a potential association with worse clinical outcomes. Conclusions Post-SRS hemorrhage in MBM is not uncommon and represents an important clinical consideration in treatment planning. Prospective studies with standardized hemorrhage charac...