Neoadjuvant vs. Intraoperative vs. Adjuvant Resection Cavity Radiotherapy of Brain Metastases

Inclusion Criteria: * Histologically confirmed solid malignancy * Metastatic brain disease (1-10 brain metastases), with at least one brain metastasis in a non-eloquent location (i.e. motor or speech) planned for resection * Maximum size of the brain metastasis \<5cm * Eligibility of patients for both stereotactic radiotherapy and resection * Time interval from resection to adjuvant stereotactic radiosurgery of 2-6 weeks * Time interval from neoadjuvant stereotactic radiosurgery to resection of 1-7 days * Possibility to postpone resection for neoadjuvant stereotactic radiosurgery, if applicable * Karnofsky performance scores \>= 70 or Eastern Cooperative Oncology Group (ECOG) \>= 2 at enrollment * Age ≥ 18 years of age * For women with childbearing potential, (and men) adequate contraception. * Ability of subject to understand character and individual consequences of the clinical trial * Written informed consent (must be available before enrolment in the trial) Exclusion Criteria: Necessity of immediate surgical resection due to life threatening symptoms * brain metastasis directly located (≤10mm) next to the optic system or brain stem * Refusal of the patients to take part in the study * Small-cell lung cancer (SCLC) or hematologic malignancy as primary malignant illness * Leptomeningeal disease suspected RadCav Trial Protocol Version 1.1, 01.07.2022 18 * Previous radiotherapy of the brain * Contraindication for contrast-enhanced MRI * Pregnant or …