Objective: To evaluate the safety and efficacy of radio-chemotherapy for middle-late stage patients with pancreatic carcinoma. Methods: MEDLINE,EMBASE,the Cochrane Library,CNKI and Wanfang Database were searched without language limitation. The end of time was at January 1st,2011. All randomized controlled trials comparing chemotherapy or radiotherapy alone with radio-chemotherapy for treating middle-late stage pancreatic carcinoma were identified and screened by two reviewers and the methodological quality of the included randomized controlled triads were evaluated by mediated Jadad scale. The RevMan4.2 software Wits was used for the analysis of the dam extracted from the included randomized controlled trials. Results: Eighteen randomized controlled trials involving 944 patients were included with 17 trials published in Chinese and 1 in English language. Meta-analysis of the data extracted from the included randomized controlled trials showed the radio-chemotherapy could significantly improve the overall survival rates compared with chemotherapy or radiotherapy alone,the corresponding relative risk(RR) values(95%CI) for the 6-month,l,2,and 3-year survival rate were 3.01(1.88~4.79),1.97(1.48~2.63),3.55(2.04~6.17)and 3.92(1.07~14.34)respectively;and the effective rate of tumor and pain relief rate were 3.18(2.25~4.50) and 2.85(1.85~4.41). Side effects of the radio-chemotherapy were reported in 15 randomized controlled trials mainly hematopoietic toxicity including leucopenia and thrombocytopenia;gastrointestinal tract effect including nausea,vomit,hiccups,loss of appetite,indigestion,the bowel movement times increasing,gastric and duodenal mucosal ulcer,diarrhea;The neuro-toxicity and fever were observed in some patients. Conclusion: The general analysis showed that compared with radiotherapy and chemotherapy alone,radio-chemotherapy could improve total survival rate for patients with late-stage pancreatic carcinoma,the catabatic rate of pain and tumor focus efficacy rate,higher safety and was a better method of treating middle-late stage pancreatic carcinoma.