{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:33:12Z","timestamp":1777926792022,"version":"3.51.4"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1181","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We sought to identify factors associated with prognosis and bleeding in patients with melanoma brain metastases (BM). Objectives were median overall survival (mOS [months]) and bleeding incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of patients receiving stereotactic radiosurgery (SRS) at our centre 11\/15-11\/23. Analysis was performed on Prism 10.1.1. Extraction from electronic medical records was undertaken by authors, with local R&amp;D approval (NEU012).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 81 patients were evaluable. One hundred and nineteen treatment courses were delivered. There were no bleeding events (BEs) in the first 7\u2009days, 1 within 28\u2009days (0.8%) and 19 within 90\u2009days (16%). Overall, 7.6% (N\u2009=\u20099) died within 90\u2009days, and 25.2% (N\u2009=\u200930) died within 6\u2009m. There were no deaths within 30\u2009days or related to treatment. mOS was 17.6\u2009m (95% confidence interval [CI] 9.20-35.05). Significantly inferior survival outcomes were observed for patients with elevated lactate dehydrogenase (LDH), poor performance status (Karnofsky performance status [KPS]), higher total treated intracranial volume (gross target volume [GTV]), and total number of BM. mOS of patients with a normal LDH was 37.0\u2009m vs 5.2\u2009m for those with LDH &amp;gt; upper limit of normal (ULN) (HR 4.40, P&amp;lt;.0001). This was also true on multivariable analysis including KPS, BM number, and BM size (HR 3.75 95% CI, 1.94-7.30, P \u2264.0001). For patients with KPS \u226590, mOS was 35.0\u2009m vs 7.7\u2009m for KPS \u226480 (HR 2.55, P&amp;lt;.0004). This was significant using the multivariable analysis described above (HR 2.12 95% CI, 1.123-3.948, P\u2009=\u2009.0181).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite theoretically high risk of bleeding after SRS in MM BM, incidence of bleeding in our cohort was low. mOS was comparable to historical controls of 16-23\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>We novelly performed univariate and multivariate analysis demonstrating poor survival outcomes in patients with high LDH, poor performance status, and larger BM (both by BM size and number).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag022","type":"journal-article","created":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T20:49:45Z","timestamp":1769374185000},"page":"906-912","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of stereotactic radiosurgery in the management of brain metastases in patients with metastatic melanoma"],"prefix":"10.1093","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5827-3464","authenticated-orcid":false,"given":"David J","family":"McMahon","sequence":"first","affiliation":[{"name":"Skin and Renal Medical Oncology Unit, The Royal Marsden Hospital NHS Foundation Trust , London SW36JJ,","place":["United Kingdom"]},{"name":"Melanoma and Kidney Cancer Team, The Institute of Cancer Research , London, SW7 3RP,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Aboulela","sequence":"additional","affiliation":[{"name":"Skin and Renal Medical Oncology 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