BACKGROUND AND OBJECTIVESkeletal metastase is one of the most common complications related to advanced cancer. The aim of this study is to analyze the effectiveness and safety of radiotherapy plus intravenous bisphosphonates versus radiotherapy alone for treating bone metastasis.

METHODSWe searched the Cochrane Library, PubMed, EMBASE, CBM, CNKI and VIP, as well as the reference lists of reports and reviews. The quality of included trials was evaluated by the Cochrane Handbook. Data were extracted and evaluated by two reviewers independently. The Cochrane Collaboration's Rev-Man 5.0 was used for data analysis.

RESULTSTwenty-two trials involving 1 585 patients were included. Compared with radiotherapy alone, radiotherapy plus intravenous bisphosphonates was more effective in total effective rate of pain relive (RR = 1.21, 95% CI: 1.13-1.30, P < 0.001), average abated time (WMD = 16.00, 95% CI: 10.12-21.88, P < 0.001), and quality of life (RR = 1.25, 95% CI: 1.08-1.45, P = 0.003, with significant differences. Side effects have no significant differences between the two groups except fever (RR = 5.61, 95% CI: 3.11-10.13, P < 0.001).

CONCLUSIONCurrent evidence supports more effective of radiotherapy plus intravenous bisphosphonates for bone metastases. The combine treatment is safe and effective.