使用 EORTC QLQ-BR23 问卷 (BR23) 系统回顾乳腺癌 (BC) 患者报告的手臂症状 (AS) 的危险因素，考虑放射治疗 (RT) 的影响。PubMed、Embase、Cochrane Library、MEDLINE 和 Web截至 2024 年 3 月 5 日，使用关键词“乳腺肿瘤”、“放射治疗”和“BR23”检索了《科学》杂志。单变量和多变量分析。妊娠、复发、远处转移 BC、再照射或缺乏 RT。使用批判性评估技能计划（CASP）清单评估纳入论文的偏倚风险。使用风险比 (RR) 或标准化均差 (SMD) 和 95% 置信区间 (CI) 作为效果指标进行描述性和荟萃分析。如果 I2 > 50%，则应用随机效应模型。纳入了 734 项研究中的 18 项，样本量范围为 172 至 2208。常见报告的危险因素包括腋窝淋巴结清扫术 (ALND)、乳房切除术、化疗 (CT)、和 RT（分别为 6、5、4 和 4 项研究）。在荟萃分析中，ALND 是手臂疼痛 (RR [95% CI] = 1.75 [1.14; 2.71])、淋巴水肿 (RR [95% CI] = 5.41 [3.48; 8.39]) 和总体 AS (与前哨淋巴结活检相比，SMD [95% CI] = 0.49 [0.14；0.83]）。 RT 不是危险因素，但与无腋窝 RT 相比，腋窝 RT 显着增加了总体 AS (SMD [95% CI] = 0.55 [0.40; 0.70])。ALND 和乳房切除术是患者报告的 AS 的主要危险因素。腋窝放疗是一个重要的风险因素，而一般放疗则不是。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

To systematically review risk factors for patient-reported arm symptoms (AS) in breast cancer (BC), considering radiotherapy (RT) impact, using the EORTC QLQ-BR23 questionnaire (BR23).PubMed, Embase, Cochrane Library, MEDLINE, and Web of Science were searched using the keywords "breast neoplasms", "radiotherapy", and "BR23" up to March 5th, 2024.both univariate and multivariate analyses.pregnancy, recurrence, distant metastasis BC, reirradiation, or lack of RT. The risk of bias of included papers was assessed using the Critical Appraisal Skills Program (CASP) checklist. Descriptive and meta-analyses were conducted using risk ratio (RR) or standardized mean difference (SMD) with 95 % confidence intervals (CI) as effect measures. A random-effects model was applied if I2 > 50 %.Eighteen out of 734 studies were included, with sample sizes ranging from 172 to 2208. Commonly reported risk factors included axillary lymph node dissection (ALND), mastectomy, chemotherapy (CT), and RT (6, 5, 4, and 4 studies, respectively). In meta-analyses, ALND was a risk factor for arm pain (RR [95 % CI] = 1.75 [1.14; 2.71]), lymphedema (RR [95 % CI] = 5.41 [3.48; 8.39]), and overall AS (SMD [95 % CI] = 0.49 [0.14; 0.83]) compared to sentinel lymph node biopsy. RT was not a risk factor, but axillary RT significantly increased overall AS (SMD [95 % CI] = 0.55 [0.40; 0.70]) compared to no axillary RT.ALND and mastectomy were the primary risk factors for patient-reported AS. Axillary RT was a significant risk factor, whereas general RT was not.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.