When do you recommend prophylactic treatment of spinal metastasis(-es) after initial identification on staging imaging for a metastatic solid tumor?  

The closest thing that I have done to prophylactic spinal (vertebral body) treatment would be if someone has a symptomatic spinal metastasis very close (within 2 vertebral bodies) that is going to have radiation treatment. I might include the asymptomatic one so that later there is less probability ...