Surgery and Whole Brain Radiotherapy (RT) Versus Whole Brain Radiotherapy (RT) and Radiosurgery for 1-3 Resectable Brain Metastases

Inclusion Criteria:

* Histopathology of primary tumors: all but primary small cell cancer, germ cell tumors, leukemia, lymphoma, or primary central nervous system.
* Primary-site: controlled, meaning operated and / or irradiated; without detectable local tumor activity
* Lack of extra-cranial metastases
* Absence of prior brain irradiation
* Number of brain metastases: 1-3
* Location of brain metastases: brain regions eligible for surgery (non-eloquent areas) and RC (metastases with largest diameter ≤ 3 cm, volume \<15 mL, and\> 5 mm from the optic chiasm, optic nerves, thalamus, hypothalamus, basal ganglia base, optic tract, optic radiation, midbrain, pons, medulla, corpus callosum, internal capsule, hippocampus and amygdala, and \<10 ml of brain tissue receiving ≥ 12 Gy).
* Metastasis-that does not cause significant mass effect and hydrocephalus or herniation requiring urgent surgical intervention
* Second uncontrolled primary tumor site: none, except non-melanoma skin cancer
* Absence of comorbid conditions that prevents surgery for resection of brain metastases
* Absence of connective tissue disease such as lupus erythematosus or scleroderma
* Patients in chemotherapy need to have their chemotherapy treatment suspended.
* Patients must consent to be followed by clinical staff of the Barretos Cancer Hospital (HCB).
* KPS: ≥ 70%
* Neutrophils ≥ 1800 cells / mL until 14 days prior to study entry
* Platelets ≥ 100,000 cells / mL until 14 days prior to study entry
* Hemoglobin ≥ 10 g / dL 14 days prior to entering the study (transfusion is allowed to achieve required concentration)
* Creatinine ≤ 1.7 mg / dL 14 days prior to study entry
* BUN ≤ 30 mg / dL 14 days prior to entry on study
* Bilirubin ≤ 2 mg / dL 14 days prior to study entry
* TGO/TGP Up to three times normal on examination until 14 days prior to study entry Prothrombin time-INR \<1.4 at examination until 14 days prior to study entry
* Systolic pressure ≤ 160 mm Hg and diastolic pressure ≤ 90 mm Hg at examination until 14 days prior to study entry Electrocardiogram-without acute myocardial infarction in examination until 14 days prior to study entry
* No active bleeding or pathological condition that entails high risk of bleeding
* Negative pregnancy test at least 14 days prior to study entry
* Informed Consent: The patient will be informed of the investigational nature of treatment and only enter the study after agreeing to participate in the study signed a consent form that informs the side effects and possible benefits and potential of both modalities treatment.

Exclusion Criteria:

* Metastasis in the posterior fossa, because this patient will be operated.