This research study is a Phase III clinical trial. Phase III clinical trials examine the
safety and effectiveness of a treatment, often comparing it to another known treatment. In
this case, the investigators are specifically looking at differences between two forms of
radiation treatment in terms of subsequent quality of life.
In this research study, the investigators are comparing stereotactic (focused, pinpoint)
radiation (in which each tumor is narrowly targeted) against whole brain radiation (radiation
targeting the entire brain) in the treatment of brain metastases. Currently whole brain
radiation is the standard option for patients with 5-20 brain metastases. Stereotactic
radiation is the standard option for patients with 1-4 brain metastases. Among patients with
1-4 brain metastases, recently published studies suggest that stereotactic radiation results
in fewer neurologic side effects than whole brain radiation. It also yields better quality of
life in this population. It remains unknown whether stereotactic radiation improves quality
of life in patients with 5-20 brain metastases relative to whole brain radiation. In this
study, the investigators seek to determine which of the two methods of study treatment
results in a better subsequent quality of life for patients with 5-20 brain metastases.