骨转移是晚期癌症患者常见的发生部位，可能会导致疼痛和其他骨骼相关事件（SRE）。自20世纪80年代以来，前瞻性临床试验已经证明了外照射放疗（EBRT）用于缓解症状性病变引起的疼痛的高功效。在不复杂的骨转移中，包括那些没有病理性骨折、脊髓压迫或先前手术干预的骨转移，经放疗后改善或完全缓解疼痛的效果高达60%，单次或多次分次放疗的功效没有区别。单次放疗的能力使得EBRT即使适用于身体状况较差和/或预期寿命较短的患者也具有吸引力的治疗。即使是有并发症的骨转移患者（如脊髓压迫），几个随机试验也证明了类似的缓解疼痛率以及诸如步态的改善等功能性结果。在本综述中，我们总结了EBRT减轻疼痛性骨转移的作用，并探讨了其在其他终点的作用，包括再钙化、SRE的预防等。版权所有©2022 Elsevier Inc.。

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.Copyright © 2022 Elsevier Inc. All rights reserved.