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

To learn whether giving spinal stereotactic radiosurgery (SRSS) that uses a more advanced imaging scan method called Magnetic Resonance imaging with a Linear Accelerator (MR-LINAC) during treatment will lead to improved responses to treatment and better quality of life. SRSS is radiation therapy given to the area around your spine.

INCLUSION CRITERIA: 1. Age ≥ 18 years old 2. Radiographically documented disease of the spine within 4 weeks of registration (candidates with or without epidural disease allowed) 3. Candidate for spine SRS/SBRT as determined by treating Radiation Oncologist or Multidisciplinary Spine Conference review 4. Maximum of 3 contiguous vertebral levels involved with metastasis in the spine to be irradiated allowed 5. Diagnosis of cancer documented 6. Motor strength ≥ 4 out of 5 in the extremity affected by the level of spinal disease planned for radiation 7. Karnofsky Performance score (KPS) ≥ 40 or ECOG score ≤ 3 EXCLUSION CRITERIA: 1. Patients with highly radiosensitive histologies likely to respond to conventional radiation therapy alone (ie lymphoma, multiple myeloma, etc) 2. Patients who are unable to undergo MRI of the spine with contrast 3. Patients who are pregnant