Neoadjuvant Radiosurgery for Resectable Brain Metastases: Phase I/II Study

Inclusion Criteria:

* Have a prior histologic diagnosis of cancer other than small cell lung cancer, lymphoma, and germ cell histologies
* Magnetic resonance imaging (MRI) evidence of 1-4 brain metastases, with at least one lesion \> 20 mm and ≤ 50 mm in maximal diameter and determined to be appropriate for SRS and gross total resection; all other brain metastases are appropriate for SRS
* Patient can have prior SRS to lesions other than the one planned for neoadjuvant SRS and resection
* Patient must have a Karnofsky performance score of ≥ 70

Exclusion Criteria:

* Patient deemed medically unfit to undergo surgical resection of brain metastasis
* Prior whole brain radiotherapy
* Patient with contraindication for imaging with MRI
* Inability to participate in study activities due to physical or mental limitations
* Inability or unwillingness to return for all the required follow-up visits
* At the time of planning, unable to deliver 10 Gray (Gy) or less to optic nerve/chiasm
* Tumor located in the brainstem
* Imaging or cytologic evidence of leptomeningeal disease