ASTRO has recently published evidence-based clinical practice guidelines on several commonly encountered clinical scenarios in Radiation Oncology Practice — Bone Metastases, Brain Metastases, and Palliative Lung Cancer. In each of these areas there either exists or is emerging significant data in terms of benefit of highly conformal therapies such as Stereotactic Radiosurgery. Given the rapid evolution and utilization of technology paralleled with increased oversight and restriction of re-imbursement from payors, radiation oncologists can be placed in a difficult situation in terms of benefit/risk and cost issues relative to their patients. In this session, we will review data on Palliative Radiotherapy and Therapeutic results with both conventional techniques and SRS/SBRT. Presenters will discuss the status of data, benefits and risks of varying treatment strategies and implications in terms of quality of care and reimbursement. At the conclusion of this activity, the learner will be able to do the following: 1. Outline data from published guidelines on evidence-based therapeutic recommendations on the treatment of bone metastases, brain metastases and palliative lung cancer. 2. Discuss data on the use of intracranial SRS for CNS metastases. 3. Discuss data on the use of SBRT for extracranial metastases. 4. Discuss relevant issues in terms of quality of care and cost.