Inclusion Criteria:

- Age ≥ 18

- Prior non-hematogenous, histologically proven malignancy (specific exclusions are
multiple myeloma and lymphoma)

- Pain attributable to one or two radiographically apparent metastatic lesion(s)
amenable to ESRT

- Have had prior radiation to area of spine felt to be cause of patient's pain

- Zubrod performance status of 0-3

- Life expectancy of ≥ 3 months

- Signed informed consent prior to registration to study

- Radiographic evidence of stable disease outside of the spinal column for at least 6
weeks prior to study entry, as evaluated by pre-study imaging.

Exclusion Criteria:

- Women who are pregnant or nursing

- Either 'no evidence of other active cancerous disease' or 'other sites of known
disease are locally controlled'

- No radiographic evidence of spinal instability (e.g. spinal cord compression
requiring immediate surgical intervention)

- No initiation of chemotherapy within 15 days of trial entry.

- No plans for concomitant antineoplastic therapy (including standard fractionated RT,
chemotherapy, biologic, vaccine therapy, or surgery) for at least 15 days following
stereotactic radiosurgery.

- No active systemic infection.

- No evidence of myelopathy or cauda equina syndrome on clinical evaluation