Stereotactic radiosurgery in the management of cancer pain

Pain can be a significant problem for the patient with advanced cancer, particularly if bone metastases are present. Radiation therapy is efficacious and has been a mainstay in the treatment of pain from bone metastases. In the past decade, radiosurgery has developed into a successful adjunct treatment for these patients. The indications for radiosurgery are continually expanding, and new and more sophisticated equipment is being developed to deliver more precise treatments. This article discusses the biology, rationale, evolution, and future direction of radiosurgery for the treatment of pain related to bony metastatic disease.