A Phase I/II Dose Escalation Study Using Extracranial Stereotactic Radiosurgery to Control Pain

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