Stereotactic Radiation Therapy Before Surgery for the Treatment of Resectable Brain Metastases

Inclusion Criteria:

* Prior histologic diagnosis of cancer other than small cell lung cancer, lymphoma, and germ cell histologies
* 1?4 cerebral metastases per magnetic resonance imaging (MRI) with at least 1 being dominant and eligible for resection
* No prior radiation treatment for the index brain metastases
* Systemic disease staged within previous 8 weeks and not rapidly progressing, with concern of life expectancy \> 3 months
* The patients will have been evaluated by the multidisciplinary team, and surgery must be deemed necessary as a result of indications including but not limited to mass effect or symptomatic lesion. Surgery must be deemed non?emergent or non?urgent clinically by the neurosurgeon
* Karnofsky performance status (KPS) \>= 70
* No active infections requiring systemic antibiotics
* If a woman is of childbearing potential, a negative serum pregnancy test must be documented. Women of childbearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; or abstinence) for duration of study participation and for up to 4 weeks following the study treatment
* Ability to understand and willingness to sign a written informed consent

Exclusion Criteria:

* Patient deemed medically unfit to undergo surgical resection of brain metastasis
* Prior whole brain radiotherapy
* Patient with contraindication for imaging with MRI
* Surgery is considered emergent or urgent by the neurosurgeon due to symptoms or concerning mass effect noted on imaging
* Patients who are participating in a concurrent treatment protocol
* At the time of planning, unable to meet dose tolerance of the optic nerve/chiasm
* Tumor located in the brainstem
* Imaging or cytologic evidence of leptomeningeal disease
* Concurrent uncontrolled illness including, but not limited to, any of the following: Symptomatic congestive heart failure, unstable angina pectoris, psychiatric illness