A Phase III Randomized Trial Of The Role Of Whole Brain Radiation Therapy In Addition To Radiosurgery In The Management Of Patients With One To Three Cerebral Metastases

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Diagnosis of cerebral metastases meeting all of the following requirements:

- 1-3 de novo lesions

- Metastases must be from a histologically confirmed extracerebral primary site,
another metastatic site, or from the metastatic brain lesion(s)

- Each lesion must be less than 3.0 cm by contrasted MRI of the brain

- Lesions must not be within 5 mm of optic chiasm or within the brainstem

- No primary germ cell tumor, small cell carcinoma, or lymphoma

- No leptomeningeal metastases

- Eligible for treatment with gamma knife or linear accelerator-based radiosurgery

PATIENT CHARACTERISTICS:

Age:

- 18 and over

Performance status:

- ECOG 0-2 OR

- Zubrod 0-2

Life expectancy:

- Not specified

Hematopoietic:

- Not specified

Hepatic:

- Not specified

Renal:

- Not specified

Other:

- Not pregnant

- Negative pregnancy test

- Fertile patients must use effective contraception

- Male patients must continue to use contraception for 3 months after the
completion of radiotherapy

- No pacemaker or other MRI-incompatible metal in body

- No known allergy to gadolinium

- Deemed to be at low risk for recurrence from any prior malignancies

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Not specified

Chemotherapy:

- At least 7 days since prior chemotherapy

Endocrine therapy:

- Concurrent hormonal agents allowed

- Concurrent steroids allowed

Radiotherapy:

- See Disease Characteristics

- No prior cranial radiotherapy

Surgery:

- No prior resection of cerebral metastasis

Other:

- Concurrent anticonvulsants allowed provided therapeutic serum/plasma level maintained
before study intervention