Postoperative Edge (RapidArc) Stereotactic Body Radiotherapy for Spinal Metastases

Inclusion Criteria:

1. Age 18 to 80 years, any sex.
2. Karnofsky Performance Status (KPS) \>= 60 or ECOG Performance Status \<= 2.
3. Confirmed spinal metastases from solid tumors by pathology or imaging (MRI/CT).
4. Postoperative imaging confirming residual epidural spinal cord compression (MESCC) requiring adjuvant radiotherapy.
5. Number of lesions \<= 5, and maximum diameter of a single lesion \<= 5 cm.
6. Interval between surgery and radiotherapy \<= 4 weeks.
7. Signed informed consent and willingness to participate in the study.

Exclusion Criteria:

1. Uncontrolled primary tumor (e.g., extensive metastasis or progressive disease).
2. Concurrent brain metastases or other active malignancies.
3. Pathological fracture or severe spinal instability requiring emergency surgical intervention.
4. Prior cumulative spinal cord radiation dose exceeding the tolerance threshold (e.g., previous spinal cord Dmax \>= 45 Gy).
5. Contraindications to radiotherapy (e.g., severe cardiopulmonary dysfunction, coagulation disorders).
6. Severe postoperative complications (e.g., infection, poor wound healing) requiring delayed radiotherapy.
7. Incomplete or unreliable medical records from external hospitals.
8. Pregnant or lactating women.