Abstract: Objective To investigate the level of β-C-terminal telopeptide of type Ⅰ collagen（β-CTX）and osteocalcin （OST） in patients with bone metastases before and after radiotherapy and their correlation with clinicopathological characteristics and response to radiotherapy. Methods The serum OST and β-CTX in 34 patients with bone metastases were tested by electrochemiluminescence immunoassay. The relation between the level of OST， β-CTX and clinicopathological characteristics were assessed. Thirty-four patients were divided into two groups， one group received only radiation of bone metastases and the other group was treated with radiation+zoledronic acid. The correlation between the level of serum OST， β-CTX before and after radiotherapy and the response to radiotherapy were analyzed. Results The levels of serum OST and β-CTX in 34 patients before treatment were（17.07±9.03）ng／ml and（593.94± 319.26）pg／ml， respectively. The serum β-CTX had correlation with the grade of bone metastases， skeletal related events and soft tissue mass， but not related to type of bone metastases and degree of metastatic bone pain， while the OST level was not correlated with clinicopathological characteristics. The level of βCTX after treatment in radiotherapy group was higher than that before radiotherapy （P＜0.05）， while in radiotherapy+zoledronic acid group was lower than that before treatment （P＜0.05）， and the level of OST before and after treatment had no significant difference （P＞0.05）. The levels of β-CTX and OST before treatment in effective group were lower than those in ineffective group （P＜0.05）. The β-CTX levels decreased after treatment in radiotherapy+zoledronic acid group no matter how the efficacy was. The βCTX levels increased in the nonresponding patients treated with radiotherapy alone （P＜0.05）， and the increase was not statistically significant in the responder （P＞0.05）.The OST levels in the two groups showed no change after radiotherapy （P＞0.05）. Conclusion The levels of bone metabolic marker β-CTX have important significance in disease condition evaluation and radiation efficacy prediction of bone metastases with application values in clinical practice.