Phase II Trial of LINAC Stereotactic Radiation, Delivering Precise DNA-Damaging Therapy for Brain Metastases

This study evaluates same-day adaptive LINAC-based stereotactic radiation comparing a 0mm versus a 1mm margin in patients with brain metastases from solid tumors. The design randomizes participants to receive high-precision external beam radiation that induces DNA damage in tumor cells, aiming to improve target accuracy amid treatment delays; typical SRS margins (~1–2 mm) balance control vs necrosis—testing 0 mm vs 1 mm could reduce toxicity without sacrificing local control.