Study Comparing Neoadjuvant Versus Adjuvant Stereotactic Radiotherapy of Brain Metastases

The purpose of this study is to evaluate the local control rate on the target lesion at 6, 12, and 24 months after treatment with neoadjuvant stereotactic radiotherapy (SRS NEO group) compared to standard care, adjuvant stereotactic radiotherapy (POST OP SRS group).

Inclusion Criteria: * Patients aged 18 years and older; * Patients with 1 to 12 brain metastases on preoperative MRI, at least one of which (contrast enhancement of at least 1 cm) is accessible for the most complete possible resection (target lesion); * Patients with a Karnofsky performance score of ≥ 70; * Patients able to perform neurocognitive tests without assistance; * Patients who understand the study and agree to attend all visits; * Patients who have signed a written informed consent form; * Affiliation with a social security system. Exclusion Criteria: * Patient who has already been treated with surgery, radiosurgery, and/or radiotherapy for the target brain metastasis; * Medical contraindication to MRI; * Patient with an estimated life expectancy of ≤ 3 months; * Patients participating in another clinical trial, or who are in the exclusion period of another clinical trial; * Patients unable to complete a self-administered questionnaire; * Patients from a vulnerable population.