Sahgal A, Myrehaug SD, Siva S, et al. - Researchers undertook this open-label, multicentre, randomised, controlled, phase 2/3 trial to compare complete response rates for pain following stereotactic body radiotherapy or conventional external beam radiotherapy in patients experiencing painful spinal metastasis. This inquiry was conducted in Canada and Australia, and included 229 patients. All these eligible patients were randomized (1:1) to receive either stereotactic body radiotherapy at a dose of 24 Gy in two daily fractions or conventional external beam radiotherapy at a dose of 20 Gy in five daily fractions employing standard techniques. The proportion of patients with a complete response for pain at 3 months post-radiotherapy, was set as the primary endpoint. Findings demonstrated the superiority of stereotactic body radiotherapy (at a dose of 24 Gy in two daily fractions) over conventional external beam radiotherapy (at a dose of 20 Gy in five daily fractions) in improving the complete response rate for pain. In the light of the findings of this study, conformal, image-guided, stereotactically dose-escalated radiotherapy affords a suitable option in the palliative setting for symptom control for selected cases with painful spinal metastases, and there is a requirement for an elevated awareness of the necessity for specialised and multidisciplinary involvement in the delivery of end-of-life care.