Note that they are studying switching the order of treatment to radiation therapy first (SRS) and surgery second to see if they can help limit LM mets
"This Phase II trial will investigate the safety, tolerability, and effectiveness of changing the order of receiving radiation therapy for treating brain cancer and brain metastases. Normal procedure is to follow surgical removal of a brain metastases with stereotactic radio surgery. This trial reverses the order of these treatments in the hope that doing the radiation first will lower the risk of cancer spreading throughout the spinal fluid which covers the brain and spinal cord, causing leptomeningeal metastases. Patients with smaller brain metastases will start at a lower dose of radiation than those with larger brain metastases. To qualify for the trial patients must have brain metastases that can be removed by surgery. The metastases must be between 2 and 6 cm in size and no more than four in number."
Dose Escalation/De-escalation Study of Pre-operative Stereotactic Radiosurgery for Brain Metastases(RAD 1002)
https://clinicaltrials.gov/show/NCT01252797