Bone is a common site for metastases, which may cause pain and other skeletal-related events (SRE) in patients with advanced cancer. Since the 1980s, prospective clinical trials have demonstrated the high efficacy of external beam radiotherapy (EBRT) for pain relief from focal, symptomatic lesions. In uncomplicated bone metastases, which include those without pathologic fracture, evidence of cord compression, or prior surgical intervention, improvement or complete pain relief with radiotherapy is as high as 60%, with no difference in efficacy when radiotherapy is delivered in a single or multiple fractions. The ability to treat with a single fraction makes EBRT an attractive therapy even for patients with poor performance status and/or life expectancy. Even in patients with complicated bone metastases (eg cord compression), several randomized trials have demonstrated similar rates of pain relief in addition to improved functional outcomes such as ambulation. In this review, we summarize the role of EBRT for alleviating painful bone metastases and explore its role for other endpoints including functional outcomes, recalcification, and prevention of SREs.

骨骼是转移的常见部位，可能会导致晚期癌症患者出现疼痛和其他骨骼相关事件 (SRE)。自 1980 年代以来，前瞻性临床试验证明了外照射放疗 (EBRT) 可有效缓解局灶性症状性病变的疼痛。在无并发症的骨转移中，包括那些没有病理性骨折、脊髓受压证据或既往手术干预的骨转移，放疗改善或完全缓解疼痛高达 60%，单次或多次放疗的疗效没有差异分数。用单一部分进行治疗的能力使 EBRT 成为一种有吸引力的疗法，即使对于体能状态和/或预期寿命较差的患者也是如此。即使在有复杂骨转移（例如脊髓受压）的患者中，几项随机试验表明，除了改善功能结果（例如步行）外，疼痛缓解率相似。在这篇综述中，我们总结了 EBRT 在减轻疼痛性骨转移方面的作用，并探讨了它对其他终点的作用，包括功能结果、再钙化和 SRE 的预防。