Investigators designed a study of a multimodality approach: surgery followed by hypofractionated intensity modulated radiation therapy (IMRT) using VMAT approach for patients with single, large brain metastases from solid primary tumor

Investigators designed a study to recruit patients with single, large brain metastases from solid primary tumor for a multimodality approach: surgery followed by hypofractionated intensity modulated radiation therapy (IMRT) using VMAT approach. The potential advantage of this treatment is to improve local control and to reduce toxicity compared with WBRT or SRS after surgical resection.

Inclusion Criteria:

• Age > 18 years
• Karnosky performance status (KPS) ≥70
• All Solid tumor (esclusion SCLC and Germinal tumors)
• Controlled primary tumor
• Controlled other metastatic site
• Single metastatic lesion at diagnosis
• Lesions ≥ 2.1 cm in maximum diameter (4 cm3), < 3 cm conditioning mass effect or neurological deficits or massive aedema, unknown primary tumor
• Estimated survival ≥ 3 months.
• Written informed consent

Exclusion Criteria:

• Prior WBRT
• KPS ≤ 70
• Other primary cancer
• Pregnant women