What is the best radiation therapy treatment for vertebral body metastasis with epidural extension adjacent to the spinal cord for radio-resistant tumors (melanoma, renal cell, etc.)?  

I assume you are asking about tumor abutting the cord but without neurologic symptoms from compression. Even if there is not compression, there may still be a role for surgery if there is concern about instability of the spine. A commonly used metric is the SINS score (Fourney et al. JCO 2011; 29(2...