Trial Comparing LATTICE Radiotherapy vs Moderately Dose-escalated Palliative Radiation for Patients With Metastases.

Unblinded, randomized study of 5-fraction LATTICE radiotherapy (20 Gy with an SIB to 66.7 Gy in 5 fractions) versus moderately dose-escalated palliative radiation (25 Gy in 5 fractions)

80 patients with confirmed metastatic tumor (\>2.5 cm in short axis) will be enrolled, all ≥ 12 years of age with ECOG ≤ 2. All genders and races will be included. Inclusion Criteria: * Histologically, cytologically, or radiographically confirmed diagnosis of metastatic cancer * One to two metastases in non-brain sites that are amenable to LATTICE radiotherapy: \>2.5 cm in short axis (dimension on axial imaging that is perpendicular to the longest dimension); bone metastasis can be included if the extraosseous component is \>2.5 cm in short axis * Age ≥12 * ECOG Performance Status 0-2 * For patients age 12-16, Lansky Play-Performance score 50-100 * Negative serum or urine pregnancy test within 2 weeks prior to enrollment of people of childbearing potential * All patients and/or their parents or legal guardians must sign a written informed consent. For any child less than 18 years of age, assent must also be obtained in addition to parental or legal guardian consent. Exclusion criteria: * Prior radiation therapy to the tumor to be treated * Active pregnancy * Diseases that place the patient at high risk of radiation complications including lupus, scleroderma, Li Fraumeni syndrome * The tumor to be treated is from a hematologic malignancy such as lymphoma or myeloma