ABSTRACT
Due to the complexity of sacral anatomy however, surgical treatment can be challenging with potentially high morbidity. Increasingly, stereotactic body radiation therapy (SBRT) is being used to treat metastatic disease to the sacrum, including within clinical trials. Recognising the evolving role of SBRT in the treatment of metastatic disease to the sacrum, this chapter aims to provide a practical guide on the management of disease at this site, summarising current guidelines to support this practice and highlighting the many challenges that arise when treating this area. The optimal management of metastatic disease to the sacrum is complex; however, increasingly, SBRT is being used both in general practice and within the context of clinical trials with variable consistency in approach across institutions. As clinicians treating this area, it is imperative we understand and try and address areas of uncertainty associated with treating this anatomically complex region.
