Laser Interstitial Thermal Therapy (LITT) or Surgery and Adjuvant Reirradiation for Recurrent Brain Metastases (LaSAR BeaM)

This trial compares two treatments for people with brain cancer (glioblastoma or other high-grade gliomas) that has come back after initial treatment. One option is laser heat therapy delivered through a small probe in the brain (LITT), and the other is conventional surgery. Both are followed by targeted re-irradiation. Researchers want to find out which approach is safer and more effective. **You may be eligible if...** - You have been diagnosed with a recurrent high-grade brain tumor (such as glioblastoma) - Your tumor is in a location suitable for either laser therapy or surgery - You have already received prior radiation therapy for your brain tumor - Your overall health is adequate for surgery or laser treatment **You may NOT be eligible if...** - Your brain tumor is too large or in a location that makes both treatments unsafe - You have had too many prior treatments that limit further options - Your general health is too poor to tolerate surgery or anesthesia Talk to your doctor to see if this trial is right for you.