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Stereotactic Body Radiation Therapy for Nonspine Bone Metastases: A Case-Based Radiosurgery Society Review
Yilan Liu1, Naomi Goldrich2, Kristin J Redmond3
1Department of Radiation Oncology, University of Washington, Seattle, Washington.
Practical Radiation Oncology
|April 20, 2026
Summary
Stereotactic body radiation therapy (SBRT) offers effective treatment for non-spine bone metastases (NSBM), guiding radiation oncologists on patient selection and planning for durable local control and symptom relief.
Area of Science:
- Radiation Oncology
- Medical Physics
- Oncology
Background:
- Stereotactic body radiation therapy (SBRT) is increasingly used for spine bone metastases.
- Its application is expanding to non-spine bone metastases (NSBM).
Purpose of the Study:
- To provide guidance on the appropriate utilization of SBRT for NSBM.
- To inform radiation oncologists through a case-based review of representative NSBM scenarios.
Main Methods:
- Review of three representative NSBM cases: rib, skull base, and femur.
- Literature review and discussion of future research areas.
Main Results:
- SBRT is effective for NSBM with careful patient selection, target delineation, dose prescription, and planning.
- Optimal target volume delineation can be achieved by fusing MRI or PET/CT scans.
- Margins for clinical target volume (CTV) and planning target volume (PTV) should be considered (5mm and ≤3mm, respectively).
Conclusions:
- SBRT is a viable option for oligometastatic disease aiming for local control or symptom relief.
- Fractionated SBRT may be preferred over single-fraction for organs at risk (OAR) sparing.
- Orthopedic consultation is recommended for weight-bearing, lytic, or high MIRELS score long bone NSBM.
