• Six-month local control rate [ Designated as safety issue: No ]
• One-year local control rate [ Designated as safety issue: No ]

• Six-month local control rate
• One-year local control rate

• Overall survival [ Designated as safety issue: No ]
• Distant brain recurrence [ Designated as safety issue: No ]
• Toxicity [ Designated as safety issue: Yes ]
• Quality of life [ Designated as safety issue: No ]

• Overall survival
• Distant brain recurrence
• Toxicity
• Quality of life

RATIONALE: Internal radiation therapy uses radioactive material placed directly into or near a tumor to kill tumor cells. Stereotactic radiosurgery may be able to deliver x-rays directly to the tumor and cause less damage to normal tissue. Giving internal radiation therapy after surgery with or without radiosurgery may kill any remaining tumor cells.

PURPOSE: This phase II trial is studying how well internal radiation therapy with or without stereotactic radiosurgery works in treating patients who have undergone surgery for newly diagnosed brain metastases.

OBJECTIVES:

Primary

• Determine the 6-month and 1-year local control rate in patients with newly diagnosed supratentorial brain metastases treated with brachytherapy using the intracavity GliaSite^® Radiation Therapy System (RTS) after surgical resection.

Secondary

• Determine the overall survival of patients treated with this regimen.
• Determine distant brain recurrence in patients treated with this regimen.
• Determine the toxic effects of this regimen in these patients.
• Assess the quality of life of patients treated with this regimen.

OUTLINE: This is a multicenter study.

Patients undergo surgical resection of the metastatic brain lesion(s) followed by implantation of the GliaSite^® Radiation Therapy System (RTS). Beginning within the 21 days after surgical resection, patients undergo brachytherapy using the GliaSite^® RTS over 3-7 days. Patients with tumor(s) remaining after surgery also undergo stereotactic radiosurgery 14-42 days after surgical resection and after completion of brachytherapy. Treatment continues in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, at 1 and 3 months, and then every 3 months for 2 years.

Patients are followed at 1 and 3 months and then every 3 months for 2 years.

PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.

• Procedure: conventional surgery
• Radiation: brachytherapy
• Radiation: stereotactic radiosurgery

DISEASE CHARACTERISTICS:

• Histologically confirmed metastatic carcinoma

  • Stable systemic disease staged within the past 6 weeks
  • No histology of lymphoma or small cell lung cancer

• Newly diagnosed supratentorial metastatic brain lesions

  • One to three lesions with at least 1 dominant lesion that is amenable to surgical resection as visualized on enhanced MRI

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• Karnofsky 70-100%

Life expectancy

• At least 6 months

Hematopoietic

• Not specified

Hepatic

• Not specified

Renal

• Not specified

Cardiovascular

• No uncontrolled hypertension
• No unstable angina pectoris
• No evidence of uncontrolled cardiac dysrhythmia

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No other serious infection or medical illness that would preclude study therapy

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• No prior polifeprosan 20 with carmustine implant (Gliadel^® wafer) for brain metastasis
• No prior temozolomide for brain metastasis

Endocrine therapy

• Not specified

Radiotherapy

• No concurrent external-beam radiotherapy to the brain
• No concurrent whole-brain radiotherapy

Surgery

• Not specified

Other

• No other prior or concurrent conventional or investigational systemic agents for brain metastasis