A Study of Stereotactic Body Radiotherapy (SBRT) and Surgical Stabilization for People With Cancer That Has Spread to the Bone

Inclusion Criteria: * Diagnosis of metastatic cancer with radiologic evidence of skeletal metastases * Treatment target involving humerus, radius, pelvis, sacrum, femur, or tibial diaphysis * Age at enrollment ≥18 years * Life expectancy \>3 months * Ability to tolerate radiation simulation and treatment with immobilization of involved anatomic site * Surgical candidate, as determined by the treatment team * Ability to obtain informed consent from patient or legally authorized representative in the setting of patient with impaired decision-making capacity. * Must agree to practice an effective contraceptive method (for those with reproductive potential) Exclusion Criteria: * Prior radiotherapy to the treatment site * Prior surgery involving the treatment site * Tumor volume or distribution precluding effective SBRT * Expected skin dose at the operative site ≥9 Gy * Imminently impending fracture requiring immediate stabilization surgery * Involvement of proximal tibia * Autoimmune connective tissue disorder * Administration of radiosensitizing medication 3 days before, during, and 3 days after RT * Active infection * Absolute neutrophil count \<1.0 * Pregnancy