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 Concomitant administration of radiosensitizing medication Active infection Absolute neutrophil count <1.0 Pregnancy