In the Alliance trial, postoperative radiosurgery delivered in three to five sessions reduced recurrence at the surgical site compared with a single-session approach and was linked to longer median overall survival in patients with large brain metastases. The study also reported a substantial improvement in the recurrence profile with no stated cognitive trade-off in the provided results summary. The finding adds to a growing body of evidence that fractionation choices after neurosurgery can materially change outcomes. If replicated in broader settings, the regimen could shift standard postoperative radiation planning and affect patient selection for stereotactic strategies.