Dose Escalation/De-escalation Study of Pre-operative Stereotactic Radiosurgery for Brain Metastases(RAD 1002)

Inclusion Criteria: * All subjects must have history of histologically confirmed malignancy. Brain biopsy is not required unless diagnosis is judged to be in doubt by the treating physician. * Newly diagnosed brain metastases (four or fewer by post-contrast MRI obtained within six weeks of study entry) * At least one brain metastasis (index tumor) must be within 2-6 cm in maximum diameter and deemed appropriate for surgical resection by the treating neurosurgeon. * Karnofsky performance status (KPS) of greater than or equal to 60 * Age greater than 19 * Life expectancy greater than 12 weeks * Subjects given written informed consent Exclusion Criteria: * Patients with small cell lung cancer and lymphoma are ineligible. * More than four metastases by baseline post-contrast MRI * Prior whole brain radiation therapy * Insufficient recovery from all active toxicities of prior therapies * Subjects who are deemed to be poor surgical risks by the treating neurosurgeon because of medical comorbidities * Pregnant or nursing women * Women of childbearing potential who are not using an effective method of contraception are excluded. Women of childbearing potential must have a negative urine or serum pregnancy test within 24 hours prior to administration of SRS.