Laser Interstitial Thermal Therapy (LITT) or Surgery and Adjuvant Reirradiation for Recurrent Brain Metastases (LaSAR BeaM)

Inclusion Criteria:

* Ability to understand and the willingness to sign a written informed consent document.
* Willingness to comply with all study procedures and availability for the duration of the study.
* Age ≥18 years. Because no dosing or adverse event data are currently available on the use of SRS2, children are excluded from this study.
* Karnofsky performance status ≥ 60.
* Radiographic concern for progression of a solid tumor brain metastasis that has received prior stereotactic radiosurgery ≥ 3 months prior to study enrollment.
* Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension as ≥5 mm with MRI scan.
* Have active tumor on pathology from surgery/LITT for this lesion.
* Able to safely undergo MRI imaging.
* Acceptable candidate for SRS2 per treating physician and multidisciplinary conference consensus.
* Have no radiographic evidence of leptomeningeal disease on radiology report or neuro-radiologist review.
* Patients with a prior or concurrent malignancy whose natural history or treatment does not interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.

Exclusion Criteria:

* Patients with brain metastases from hematologic malignancies due to significant differences in radiosensitivity and treatment paradigms.
* Patients with psychiatric illness/social situations that would limit compliance with study requirements.
* Pregnant women are excluded from this study because radiation has the potential for teratogenic or abortifacient effects. All female patients between the onset of menses and 55 years will receive a pregnancy test prior to SRS2 unless the patient presents with an applicable exclusionary factor which may be one of the following:
* Postmenopausal (no menses in greater than or equal to 12 consecutive months).
* History of hysterectomy or bilateral salpingo-oophorectomy.
* Ovarian failure (Follicle Stimulating Hormone and Estradiol in menopausal range, who have received Whole Pelvic Radiation Therapy).
* History of bilateral tubal ligation or another surgical sterilization procedure.