Phase I Study of Fractionated Stereotactic Radiation Therapy

Inclusion Criteria: * Pathologically proven diagnosis of a non-hematological malignancy other than small cell lung cancer within 5 years of registration * Intact (unresected) brain metastases measuring ≥3 cm and ≤ 6 cm in largest dimension on gadolinium contrast enhanced MRI obtained within 30 days prior to registration OR Surgically resected brain metastasis for which postoperative stereotactic radiotherapy is indicated, with expected target measuring ≥3 cm and ≤6 cm in largest dimension * Prior Whole Brain Radiation Therapy (WBRT) is allowed * Age ≥ 18 years * Women of childbearing potential and male participants must practice adequate contraception * History/Physical examination within 30 days prior to registration * Life expectancy \>3 months * Patients are allowed to enroll if previously treated to other lesions with Stereotactic Radiosurgery (SRS) * Patients with multiple lesions are allowed, as long there is one dominant lesion that will be treated with FSRT. Other lesions may be treated concurrently with SRS or FSRT at the discretion of the treating physician but will not contribute to the study endpoints Exclusion Criteria: * Patients with definitive leptomeningeal metastases, based on cerebrospinal fluid (CSF) examination * Plan for chemotherapy or targeted agents during treatment. Hormonal therapy, immunotherapy targeting PD-1/PD-L1 axis, and bone supportive therapy may be continued during treatment * Contraindication to enhanced MRI imaging such as implanted me…