Neoadjuvant vs. Intraoperative vs. Adjuvant Resection Cavity Radiotherapy of Brain Metastases (Radcav)

Inclusion Criteria: Histologically confirmed solid malignancy Metastatic brain disease (1-10 brain metastases), with at least one brain metastasis in a non-eloquent location (i.e. motor or speech) planned for resection Maximum size of the brain metastasis <5cm Eligibility of patients for both stereotactic radiotherapy and resection Time interval from resection to adjuvant stereotactic radiosurgery of 2-6 weeks Time interval from neoadjuvant stereotactic radiosurgery to resection of 1-7 days Possibility to postpone resection for neoadjuvant stereotactic radiosurgery, if applicable Karnofsky performance scores >= 70 or Eastern Cooperative Oncology Group (ECOG) >= 2 at enrollment Age ≥ 18 years of age For women with childbearing potential, (and men) adequate contraception. Ability of subject to understand character and individual consequences of the clinical trial Written informed consent (must be available before enrolment in the trial) Exclusion Criteria: Necessity of immediate surgical resection due to life threatening symptoms brain metastasis directly located (≤10mm) next to the optic system or brain stem Refusal of the patients to take part in the study Small-cell lung cancer (SCLC) or hematologic malignancy as primary malignant illness Leptomeningeal disease suspected RadCav Trial Protocol Version 1.1, 01.07.2022 18 Previous radiotherapy of the brain Contraindication for contrast-enhanced MRI Pregnant or lactating women Participation in another competing clinical study or observation period of competing trials, respectively