Pre-operative Stereotactic Radiosurgery Followed by Resection for Patients With Brain Metastases

Inclusion Criteria

• •1. Radiographically confirmed solid tumor brain metastases
• •2. Criteria for surgical resection of at least one metastasis per neurosurgeon discretion
• •3. A diagnostic MRI Brain or CT Head demonstrating the presence of 1-4 solid tumor brain metastases and lesion to be resected no more than 5 cm in any direction, performed within 30 days prior to stereotactic radiosurgery. If multiple lesions are present, then the total brain metastases volume can be no more than 30 cm3 excluding the lesion to be resected.
• •4. For known primary included in brainmetgpa.com, an estimated median survival no less than 6 months per brainmetgpa.com
• •5. For unknown primary or known primary not included within brainmetgpa.com, an estimated median survival no less than 6 months per PI discretion Note: If patient's estimated median survival is calculated using a histology that is different than the histology demonstrated in final pathology, the patient may remain eligible for all study endpoints per PI discretion
• •6. Surgical candidate per neurosurgeon discretion
• •7. Surgical resection able to be performed within 1 - 4 days after radiosurgery
• •8. Stereotactic radiosurgery candidate per radiation oncologist
• •9. ≥ 18 years old at the time of informed consent
• •10. Ability to provide written informed consent and HIPAA authorization. This will be assessed by the consenting physician using general questions to determine the patient's ability to understand the medical problem, proposed treatment, alternatives to proposed treatment, and understand the consequences of the medical choices.
• •11. Platelet count \> 100 k/cumm, Hgb \> 7.5 gm/dL, INR \< 1.3, ANC \> 1.5 k/cumm
• •12. Patients currently on cytotoxic chemotherapy or immunotherapy are eligible, not including anti-VEGF therapy
• •13. If a patient who meets all stated eligibility criteria is enrolled on study and then discovered to be ineligible, the tissue obtained will still be deemed eligible to remain in study for evaluation.