Phase II Cohort of Spinal Stereotactic Radiotherapy in Patients Using a MR LINAC

This study tests the use of a specialized radiation machine called an MR-Linac to deliver precise stereotactic radiotherapy (SRS/SBRT) to cancer that has spread to the spine. Unlike standard radiotherapy, MR-Linac combines real-time MRI imaging with radiation delivery, allowing doctors to precisely target spinal tumors while avoiding the spinal cord. This precision may improve tumor control and reduce the risk of nerve damage. You may be eligible if: - You are 18 or older and have cancer that has spread to the spine (confirmed on imaging within 4 weeks) - You have up to 3 consecutive vertebral levels involved with cancer - A radiation oncologist or spine team has determined you are a candidate for spine SRS/SBRT - You have adequate muscle strength in limbs affected by your spine disease (grade 4 out of 5 or better) - Your performance status is Karnofsky 40 or better (or ECOG 3 or less) You may NOT be eligible if: - Your cancer type is highly radiation-sensitive (e.g., lymphoma, multiple myeloma) and likely responds to conventional radiation - You cannot undergo an MRI with contrast of the spine - You are pregnant Talk to your doctor to see if this trial is right for you.