A Trial of Postoperative Whole Brain Radiation Therapy vs. Salvage Stereotactic Radiosurgery Therapy for Metastasis

Inclusion Criteria:

1. one to four brain metastases with a maximum diameter of 3 cm or more for the largestlesion and additional lesions not exceeding 3 cm in diameter

2. all brain metastases localized within cerebrum or cerebellum

3. before surgical resection for brain metastasis, PS is 0-2, or 3 by cerebral nervecompression neurological deficits

4. surgical resection for the largest brain metastases has achieved

5. after surgical resection, four or fewer (0-4) residual lesions with maximum diameterunder 3 cm

6. histologically proven non-small cell carcinoma, breast cancer or colorectal cancer

7. primary lesion and the other metastases (i.e. lung, liver, bone metastases except forbrain) is consider to be controlled

8. an age of 20-79 years

9. no prior surgery or irradiation for brain

10. adequate organ function

11. written informed consent(If signing in consent form is difficult for the patient dueto paralysis, signing by the family in place of the patient is permitted)

Exclusion Criteria:

1. synchronous or metachronous (within 5 years) malignancy other than carcinoma in situor mucosal cancer

2. pregnant or breast-feeding women

3. severe mental disease

4. allergic to gadolinium contained contrast agents