Randomized Trial Comparing Conventional Radiotherapy With Stereotactic Radiotherapy in Patients With Bone Metastases - VERTICAL Study

Inclusion Criteria: * Radiographic evidence of bone metastases * For spinal lesions; per lesion no more than 3 consecutive spine segments involved with one unaffected vertebral body above and below * No more than 2 painful lesions needing treatment * Histologic proof of malignancy * No compression of spinal cord * No or mild neurological signs (i.e. radiculopathy, dermatomal sensory change, and muscle strength of involved extremity is Medical Research Council (MRC) 4/5 * Medically inoperable or patient refused surgery * Karnofsky performance score (KPS) \> 50 * Numeric rating scale (NRS) \> 3 * Age \> 18 years * Written informed consent * Filling out PRESENT-questionnaires Exclusion Criteria: * Lesion in C1 or C2 * Radio-sensitive histology such as multiple myeloma, lymphoma, small cell, germ cell * Spinal MRI cannot be completed for any reason (in according with the MRI protocol of the Department of Radiology) * Impossible to delineate metastasis and organs at risk (OAR) due to artifacts on CT or MRI from previous surgical stabilization * Unable to undergo SBRT treatment, according to treating doctor's opinion * Epidural disease * Severe, worsening or progressive neurological deficit * Unstable lesion requiring surgical stabilization * Patient with \< 3 months life expectancy * Previous EBRT or SBRT to same level * Chemotherapy or systemic radionuclide delivery within 24 hours before and after SBRT