This study will evaluate the most effective radiation dose. Patients will be randomized
(like flipping a coin) to receive either low dose stereotactic radiotherapy (defined as "14
Gy") or high dose stereotactic radiotherapy (defined as 18 Gy).
This study will evaluate the pain control and the quality of life of patients with spinal
metastases using stereotactic radiotherapy. Stereotactic radiotherapy is referred to as
"targeted therapy". It uses special equipment to position the patient and guide the focused
beams of radiation toward the cancer and away from normal surrounding tissue. This higher
dose technique may work better to kill cancer cells with fewer side effects than standard
- Signed informed consent.
- Age greater than or equal to 18 years old.
- Prior histologically-proven, non-hematogenous malignancy (Specific exclusions are
multiple myeloma and lymphoma).
- Radiographic evidence of one or two non-contiguous spinal metastases amenable to SRS.
- Metastatic disease must be symptomatic (causing either pain or neurologic symptoms).
- Maximum tumor size less than or equal to 5 cm.
- Zubrod performance status of less than or equal to 3.
- Life expectancy of greater than or equal to 3 months.
- Women/Men of childbearing potential must use effective contraception.
- No prior radiation delivered to the involved area
- No evidence of spinal instability requiring urgent surgical intervention.
- No evidence of spinal cord compression requiring emergent surgical or
- No plans for concomitant antineoplastic therapy (including standard fractionated RT,
chemotherapy, biologic, vaccine therapy, or surgery) while on this protocol except at
disease progression.Concomitant is defined as within 3 days before or after
- No pregnant or lactating women.
- No active systemic infection.
- No evidence of myelopathy or cauda equina syndrome on clinical evaluation