radiation therapy of spinal metastases results with different fractionations aims and background local radiotherapy plays an important role in the palliative treatment of all skeletal metastases particularly those of the spine with the purpose to obtain pain relief and prevent pathologic fractures or vertebral collapsemethods from june 1991 to october 1993 95 patients with a total of 103 sites of spinal metastases were treated at the institute of radiology of the university of rome la sapienza fractionations and total doses were divided as single fractions of 800 cgy hypofractionated multiple fractions for a total dose of 20 gy administered in 45 days and conventional multiple fractions for a total dose of 3040 gy in 24 weeks an evaluation of the efficacy of the different radiation treatments was performed with the use of a simplified descriptive pain scaleresults seventythree 709 of 103 treatments were evaluables an overall response rate of 822 was obtained complete in 383 and partial in 438 irrespective of total dose fractionation and location of irradiated spinal metameres the analysis of results did not show significant differences between the treatment coursesconclusions we confirm that radiation therapy has a major role in the management of pain control and prevention of fractures in patients with spinal metastases hypofractionated and single fraction treatments showed equal efficacy compared to more prolonged therapy with an advantage for the patient and the radiation therapy institution