Prophylactic Radiotherapy of MInimally Symptomatic Spinal Disease

Inclusion Criteria

• •1. Histologically-confirmed solid tumor malignancy with greater than 5 sites of metastatic disease detected on cross-sectional imaging.
• •2. Has high-risk bone metastases that are asymptomatic or minimally symptomatic (not requiring opioids). High risk metastases are defined as:
• •1. Bulkiest sites of spinal osseous disease ≥ 2cm,
• •2. Disease at junctional levels, including the thoracic apex (Occiput to C2, C7-T1, T12-L2, and L5- S1)
• •3. Disease with posterior element involvement, including interspinous, unilateral, or bilateral facet joints.
• •4. Vertebral body compression deformity \> 50%.
• •3. Eastern Cooperative Oncology Group (ECOG) performance status 0 - 2.
• •4. Age ≥ 18 years.
• •5. Able to provide informed consent.
• •6. Patients at reproductive potential must agree to practice an effective contraceptive method. Women of childbearing potential must not be pregnant or lactating.