A Phase I/II Study of Fractionated Stereotactic Radiosurgery to Treat Large Brain Metastases

Inclusion Criteria:

- All patients age 18 years and older with pathologically proven solid tumor malignancy
and 1 to 4 brain metastases, one of which is 4.2 - 33.5 cm^3.

- Systemic therapy: Prior cytoxic systemic therapy must be completed >= 5 days prior
to radiosurgery. No concurrent cytoxic systemic therapy along with SRS. Cytoxic
systemic therapy to start >= 5 days after the completion of SRS.

- Prior surgery or SRS is allowed as long as the target metastatic lesion in this study
has not previously been treated with SRS.

- Patient must exhibit the ability to understand and the willingness to sign a written
informed consent.

- Life expectancy of at least 12 weeks.

Exclusion Criteria:

- Patients who have previously been treated with whole brain irradiation.

- Patients whose metastatic lesion in question had previously been treated with SRS.

- The patient has greater than 4 total brain metastases at the time of initial
evaluation.

- Pediatric patients (age <18), pregnant women, and patients who are unable to give
informed consent will be excluded.