Radiation timing for large brain tumors before or after surgery

This trial is testing hypofractionated radiosurgery (a focused type of radiation therapy given over a few days) for patients with large brain metastases (cancer that has spread to the brain) that need surgery. The study compares two approaches: receiving this radiation before surgery versus after surgery. The goal is to find the best timing and approach to control the cancer while minimizing side effects and complications.

Large brain metastases are difficult to treat, and surgery alone often isn't enough to prevent cancer from coming back. Doctors have traditionally used whole-brain radiation after surgery, but this can damage healthy brain tissue and cause memory and thinking problems. This trial is testing whether the new radiation approach—given before or after surgery—can control cancer better while causing fewer of these serious side effects.