TY  - JOUR
A1  - Zoga, Eleni
A1  - Wolff, Robert Jürgen
A1  - Ackermann, Hanns
A1  - Meissner, Markus
A1  - Rödel, Claus
A1  - Tselis, Nikolaos
A1  - Chatzikonstantinou, Georgios
T1  - Factors associated with hemorrhage of melanoma brain metastases after stereotactic radiosurgery in the era of targeted/immune checkpoint inhibitor therapies
T2  - Cancers
N2  - We aimed to evaluate the factors associated with hemorrhage (HA) of melanoma brain metastases (MBM) after Cyberknife stereotactic radiosurgery (SRS) in the modern era of systemic therapy. A total of 55 patients with 279 MBM were treated in 93 fractions. The median age, SRS dose, radiological follow-up, and time to HA were 60.4 years, 20 Gy, 17.7 months, and 10.7 months, respectively. Radiologically evident HA was documented in 47 (16.8%) metastases. Of the 55 patients, 25 (45.4%) suffered an HA. Among those, HA caused grade 3 toxicity in 10 patients (40%) and grade 1 symptoms in 5 patients (20%). Ten patients (40%) with HA experienced no toxicity. Logistic regression revealed the use of anticoagulants and the administration of systemic therapy within 7/15 days from SRS to be predictive for HA. When considering the HA causing grade 3 symptomatology, only the use of anticoagulants was significant, with the delivery of whole brain radiation therapy (WBRT) before the HA narrowly missing statistical significance. Our retrospective analysis showed that the administration of modern systemic therapy within 7/15 days from SRS may contribute to HA of MBM, though it appears safe, at least concerning grade 3 toxicity. The use of anticoagulants by the time of SRS significantly increased the risk of HA.
KW  - brain metastases
KW  - hemorrhage
KW  - immune checkpoint inhibitors
KW  - melanoma
KW  - stereotactic radiosurgery
KW  - targeted therapy
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/81928
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-819288
SN  - 2072-6694
VL  - 14
IS  - 10, art. 2391
SP  - 1
EP  - 9
PB  - MDPI
CY  - Basel
ER  -