Comparing SingLe- Vs Multi-Fraction Spine STereotActic Radiosurgery in Spinal Metastases

This trial is comparing two radiation therapy approaches for people with cancer that has spread to the spine: a single large dose of targeted radiation (single-fraction) versus several smaller doses over multiple sessions (multi-fraction stereotactic radiosurgery), to see which approach is safer and more effective. **You may be eligible if...** - You are 18 or older with a confirmed diagnosis of metastatic cancer that has spread to the spine (cervical, thoracic, or lumbar) - You have 1 to 3 separate spinal sites that need treatment - You are in reasonably good health (ECOG performance status 0-2) - You are willing to use birth control if applicable **You may NOT be eligible if...** - You have already had radiation at or overlapping with the spinal area that needs to be treated in this study - You cannot have an MRI or CT scan - Your spinal cord is already being compressed by cancer - You have widespread cancer spread to many spinal levels Talk to your doctor to see if this trial is right for you.