Clinical Research Directory

Inclusion Criteria: * Both cohorts: --≥18 years of age * ECOG performance status ≤2 * Pathologically proven metastatic solid tumor (non-hematologic malignancy) of the bone (spine or non-spine bone) * Bony metastatic lesions must be ≤6 cm in maximum dimension and evaluable on either a CT or MRI scan; metastatic lesions in the spine must involve ≤3 contiguous vertebral bodies * No other active malignancy within the past 2 years, except for non-melanoma skin cancers or carcinoma in situ of the cervix * Ability to understand and the willingness to sign a written informed consent document * Surgery to the lesion in question is allowed if size criteria outlined above are met * Not currently pregnant or breast feeding * Cohort 1: Oligometastatic state * Oligometastatic state is defined by ≤ 3 active sites of disease, including the primary site * Agreement of both the Chow et al.15 and TEACHH16 models, indicating a median life expectancy of \>3 months * Among patients with multiple sites of metastatic disease, the other sites that will not be treated on this protocol have either been previously treated or are planned for local treatment * Cohort 2: Re-irradiation * Previous radiation in the current area of disease requiring radiation * Life expectancy of \>3 months as defined by agreement of both the Chow et al.15 and TEACHH16 models Exclusion Criteria: * SBRT target size \>6 cm in maximum diameter (or \>100 cc in volume) * Hematologic malignancies (including lymphoma, multiple myeloma) * Prior RT of greater dose intensity than 100 Gy2 based on a biological effective dose (BED) calculation \[BED (Gy2) = nd x (1+d/α/ß; where n=number of fractions, d=dose per fraction, α/ß=2)\] * Epidural tumor \<2 mm from spinal cord * Requirement of active receipt of systemic therapies concurrent with SBRT (concurrent hormonal therapies are allowed) * Inability to lie flat and still for treatment delivery despite anti-anxiety and/or pain medications * Non-English speakers are excluded from this study due to use of questionnaires which have not been validated in other languages. * Patients lacking the capacity to describe their symptoms are excluded as that precludes them (or anyone on their behalf) from filling out the validated questionnaires about symptoms/toxicity. * Pregnant women are excluded from this study because radiotherapy has the potential for teratogenic or abortifacient effects. * Individuals with a history of a different malignancy are ineligible except for the following circumstances: if they have been disease-free for at least 2 years and are deemed by the investigator to be at low risk for recurrence of that malignancy; or if diagnosed and treated within the past 2 years for cervical cancer in situ or basal cell or squamous cell carcinoma of the skin.