显微手术治疗矢状窦旁脑膜瘤

目的 提高矢状窦旁脑膜瘤的手术效果,探讨手术方法和技巧.方法回顾性分析21例矢状窦旁脑膜瘤的临床资料,利用显微技术对21例矢状窦旁脑膜瘤施行肿瘤全切,同时对受累的上矢状窦进行处理,收到满意效果.结果手术全切除肿瘤21例,其中Simpson Ⅰ级切除者16例(76.19%),Ⅱ级切除者5例(23.81%).术后随访1年～2年,无手术死亡.结论采用显微手术切除矢状窦旁脑膜瘤可提高肿瘤全切除率,减少脑重要功能区的损伤,减少并发症,提高患者术后生存质量,显微外科技术治疗矢状窦旁脑膜瘤是一种安全、有效的方法.     

岩斜区脑膜瘤的显微外科手术治疗及预后影响因素分析

目的 探讨显微外科手术对岩斜区脑膜瘤的疗效及预后影响因素.方法 选取86例岩斜区脑膜瘤患者,均给予显微外科手术治疗.观察并记录患者治疗后手术切除程度、术前术后NIHSS评分,随访期间并发症情况以及影响预后的危险因素,评估显微外科手术对岩斜区脑膜瘤的疗效.结果 术后MRI复查证实全切除患者52例,占60.5％;部分切除患者34例,占39.5％.死亡3例,死亡率3.5％.术前患者NIHSS评分(23.8±4.6)分,术后患者NIHSS评分为(16.7±3.8)分,术后患者NIHSS评分明显降低(P＜0.05).随访期间,86例患者中有2例患者出现新的神经功能障碍;1例肢体功能障碍;2例癫痫;2例脑积水.经单因素分析发现年龄、术前生存质量、肿瘤类型、质地、肿瘤是否包裹神经血管、脑干水肿均是影响预后的危险因素.结论 显微外科手术是治疗岩斜区脑膜瘤的首要方法,手术操作过程中注重操作技巧,可降低手术风险,减少术后并发症.影响手术预后的因素较多,故手术治疗应根据患者基本情况制定个体化治疗方案.     

巨大鞍结节脑膜瘤的手术治疗

目的:探讨巨大鞍结节脑膜瘤手术治疗的入路选择及术中、术后注意要点.方法:对12例巨大鞍结节脑膜瘤的临床资料进行回顾性分析.结果:12例均采用显微手术下超声刀切除,其中8例恢复良好,2例死亡,2例植物生存.结论:巨大鞍结节脑膜瘤选择适当的手术入路,采取大部分切除,必要时去骨瓣可取得满意的疗效.     

鼻咽癌患者生存质量量表QOL-NPC研制中的条目筛选

背景与目的:目前,全世界广泛使用癌症患者生存质量量表、头颈癌生存质量量表、SF-36等非特异性的量表去测定鼻咽癌患者的生存质量量表;鼻咽癌患者特异性量表(scale of quality of life for nasopharyngeal carcinoma,SQOL-NPC)至今未进行更新.本研究的目的在于研制符合中国国情的鼻咽癌患者生存质量(quality of life for nasopharyngeal carcinoma,QOL-NPC)评价量表.方法:参照WHO关于生存质量的定义,在文献复习的基础上,听取肿瘤医护人员及专家、生存质量专家、鼻咽癌患者的意见,制定初步的量表.2007年1～2月,在中山大学肿瘤防治中心随机抽取鼻咽癌患者433例,采用离散趋势、相关系数、因子分析和克朗巴赫系数统计学方法筛选条目.结果:研制出QOL-NPC量表,该量表包含身体机能(physical domain,PH)、心理精神状况(psychological domain,PS)、社会关系(social domain,SO)、副作用(side effect domain,SE)4个领域共30个条目.结论:QOL-NPC量表反映了WHO关于生存质量的内涵和鼻咽癌患者的特殊问题,并按程序化方式进行条目筛选,可以认为该量表适合评价鼻咽癌患者的生存质量.     

显微外科手术应用于颅底巨大脑膜瘤的效果及并发症分析

目的 探究显微外科手术应用于颅底巨大脑膜瘤的效果及并发症发生情况.方法 选取进行显微外科手术切除颅底巨大脑膜瘤的79例患者作为研究对象.比较不同部位颅底巨大脑膜瘤患者的临床表现、影像学结果,以及术后治疗效果及并发症发生情况.结果 颅底巨大脑膜瘤患者以头痛症状最为常见,占56.96％;其次为视力障碍,共有26例患者,占32.91％;精神症状较为少见,仅有4例患者伴有精神症状,占5.06％.对患者随访1年,发现术后最常见的并发症为术后神经功能障碍加重,发生率为32.91％;其次为脑脊液漏及颅内出血,分别发生6例及5例,分别占7.59％、6.33％.79例患者中19例为嗅沟脑膜瘤,占24.05％;15例为鞍区脑膜瘤,占18.99％;15例为蝶骨嵴脑膜瘤,占18.99％;6例为岩斜区脑膜瘤,占7.59％;24例为后颅窝脑膜瘤,占30.38％.显微外科手术治疗以嗅沟区颅底巨大脑膜瘤全切率最高,术后死亡率最低,复发率最低;而治疗效果以岩斜区颅底巨大脑膜瘤最差.结论 显微外科手术应用于颅底巨大脑膜瘤的治疗,可获得较好的治疗效果及安全性,值得广泛应用于临床.     

弥散张量成像鉴别良性脑膜瘤亚型及相关研究

目的:探讨弥散张量成像(DTI)鉴别良性脑膜瘤亚型及其在手术中的应用价值.方法:57例经手术病理证实的良性脑膜瘤患者,术前均行头部MRI常规平扫及增强扫描,并加做DTI检查.结果:纤维母细胞型脑膜瘤部分各向异性(FA)值明显高于其它亚型脑膜瘤,差别有显著性意义;表观弥散系数(ADC)值各亚型间有差异,但无显著性意义.弥散张量成像能直观地显示肿瘤与重要神经纤维束的关系,纤维束受累情况与临床症状具有良好相关性.结论:FA值可以作为鉴别纤维母细胞型脑膜瘤与其它良性亚型脑膜瘤的重要参数之一,从中可获得术前关于其软硬度的信息.弥散张量成像对指导脑肿瘤手术及判断预后具有重要临床价值.     

循证医学模式对脑膜瘤患者术后并发症发生及生活质量的干预效果

目的 探讨循证模式干预对脑膜瘤患者术后并发症发生及生活质量的效果.方法 将80例脑膜瘤手术治疗患者分为对照组和观察组.对照组患者实施常规治疗,观察组患者在对照组基础上采用循证医学模式进行治疗.统计2组患者并发症发生率,采用MOS SF-36量表对2组患者生活质量进行评价.结果 观察组患者术后共有4例出现并发症,发生率为10.00%;对照组并发症发生率为22.50%(9例).观察组并发症发生率明显低于对照组.观察组患者生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、情感健康、躯体生理健康总评、心理生理健康总评得分分别为(16.27±1.18)分、(3.62±0.20)分、(1.34±0.14)分、(11.20±1.15)分、(17.62±1.35)分、(5.34±0.27)分、(5.74±0.15)分、(18.74±1.25)分、(65.41±3.87)分和(25.91±2.20)分,均明显高于对照组,且差异有统计学意义.结论 采用循证模式进行临床干预可以有效降低脑膜瘤患者的术后并发症发生率,提高患者生活质量.     

肺癌局部与肺叶切除术对高龄患者生存质量的影响

目的:探讨不同术式对高龄肺癌患者近期生存质量的影响.方法:将2004年1月-2006年12月＞70岁手术治疗后一年以上的212例肺癌患者分为A,B两组:A组93例,行肺叶切除术及淋巴结清扫术;B组119例,行肺内包块局部切除术及局部淋巴结清扫术.采用欧洲癌症治疗研究组织生存质量核心量表EORTC QLQ-C30及肺癌专用量表EORTC QLQ-LC13测评所有患者的生存质量.结果:与术前相比,出院时所有患者的生存质量均有所下降,于3-12月之内逐渐恢复.两组间比较,在整体健康状态、躯体功能、角色功能及疲劳、疼痛、呼吸困难、气促与咳嗽症状等方面B组优于A组,存在显著差异(P<0.05).结论:高龄肺癌患者术后近期内生存质量明显下降,在术后一年内逐渐恢复;肺叶切除术并淋巴结清扫术比局部切除术对高龄肺癌患者的生存质量影响更大.     

内镜辅助下经鼻蝶窦垂体瘤切除术后生存质量的多因素临床研究

背景与目的:现代医学模式要求更全面的指标来评价手术疗效,而生存质量已成为其中一个重要标准。本文探讨与内镜辅助下经鼻蝶窦垂体瘤切除术后患者生存质量相关的多种因素,为全面评估手术疗效提供依据。方法:分析116例垂体瘤患者临床资料、影像学及病理检查结果,采用生存质量量表随访近5年的相关数据,并经计算机统计分析。结果:各种类型的垂体腺瘤术后生存质量较满意,不同分型间其生存质量统计无明显差异,而肿瘤越大,生存质量越低(P<0.01);侵袭性大、手术切除程度下降、复发的垂体瘤患者术后生存质量显著降低(P<0.01)。逐步回归分析方程为:Y=120.2097-1.7140x4-8.4210x5-9.6650x6,R=0.7944;Cox模型分析示:垂体瘤大小、垂体瘤侵袭性、手术切除程度是影响生存质量的主要因素。结论:术前MRI示垂体瘤大小,侵袭程度,术中手术切除程度,可预测术后生存质量;尽量行肿瘤全切术、早期发现复发可望提高患者生存质量。     

喉癌患者术后生存质量及其影响因素的研究

目的　探讨国际常用的华盛顿医科大学生存质量 (universityofwashington QOL ,UW QOL)量表 ,在中国喉癌患者QOL研究中应用的可行性。方法　对 37例全喉切除和 81例喉部分切除的喉癌患者进行UW QOL量表问卷调查 ,比较喉全切除术和喉部分切除术后患者生存质量 (gualityoflife,QOL)的不同 ,分析喉癌患者术后影响生存质量的因素。结果　喉部分切除术组患者的QOL总分(6 92 .34± 12 7.94)高于喉全切除术组 (6 36 .35± 139.97,P <0 .0 5 ) ,说话交流和外貌方面 (74.32±2 3.82 ,80 .86± 2 0 .2 6 )显著高于喉全切除术组 (4 0 .2 7± 2 5 .76 ,6 9.5 9± 2 7.0 9;P <0 .0 0 1,P <0 .0 5 ) ;而后者在疼痛方面 (92 .5 7± 13.0 0 )要高于前者 (83.0 2± 2 0 .47;P <0 .0 1)。喉癌分期、术式、并发症、术后放化疗、与谁同住及手术前后有无慢性病是影响患者术后生存质量的因素。结论　喉部分切除术能提高喉癌患者术后整体生存质量 ,改善术后说话交流功能及外貌。UW QOL量表可用于中国喉癌患者生存质量研究。     

Postradiotherapy quality of life for head-and-neck cancer patients is independent of xerostomia

PURPOSE: To determine the relationship between quality of life (QOL) and xerostomia over time for patients undergoing radiotherapy (RT) for head-and-neck cancer in a prospective clinical trial. METHODS AND MATERIALS: Patients with head-and-neck cancer were randomized to pilocarpine (n = 65) vs. placebo (n = 65) during RT. QOL was measured using the McMaster Head and Neck Radiotherapy Questionnaire (HNRQ). Xerostomia was measured on a linear analog scale. No statistically significant differences were observed between arms; all 130 patients were analyzed together. RESULTS: Baseline QOL data were obtained for 98.5% of participants. The baseline HNRQ score of 5.7 declined significantly to 4.0 (p <0.0001) by RT Week 6 and returned to baseline (5.8) by 6 months after treatment. This represents a large, clinically important change of 1.7 of 7 (24%; effect size 1.34). The decline in HNRQ score during RT paralleled the onset of xerostomia on the linear analog scale (r = 0.36 at 1 month). After treatment, the QOL scores recovered without improvement in xerostomia. The trajectory of the linear analog scale score resembled that of the HNRQ's single xerostomia question (r = 0.75 at 1 month). CONCLUSION: Quality of life recovers to baseline after RT, despite persistent xerostomia. Either a response shift occurs or xerostomia in the absence of acute mucositis has a relatively small influence on overall QOL.     

Evaluation of the quality of life between inpatients and outpatients receiving cancer chemotherapy in Japan

A quality of life (QOL) assessment has become increasingly common in cancer clinical trials. Seventy-four consecutive patients treated for cancer between August 2005 and January 2006 at the Cancer Chemotherapy Center in the University of Occupational and Environmental Health, Japan, were examined. The 8-Short form health survey (SF-8) was utilized as a comprehensive scale and quality of life questionnaire for cancer patients treated with anticancer drugs (QOL-ACD) as disease specific scale for the QOL evaluation. The QOL for outpatients was investigated in comparison with that for inpatients. All questionnaires were collected and baseline questionnaires were filled in by 98.1% of the subjects. The physical comprehensive score (PCS) of SF-8 for the outpatients was higher than that for the inpatients. The physical condition of the outpatients was better than that of inpatients. There was no difference in the baseline scores of the QOL-ACD scales in daily activity, psychological condition, social attitude, and face scale of the analyzed domains between the two groups. Furthermore, a longitudinal study from admission to outpatient was carried out on 27 patients who were treated on an outpatient basis in our clinic. No difference in the baseline scores of the SF-8 and QOL-ACD scales were observed in any of the analyzed domains. These data suggest that the present QOL study has a sufficient feasibility for the outpatients evaluated in our study, and QOL of outpatients after discharge is equal to that of inpatients receiving cancer chemotherapy.     

TURBT术后序贯放化疗治疗对老年 MIBC 患者生存时间及生活质量的影响

目的:探讨经尿道膀胱肿瘤电切术（transurethral resection of bladder tumor,TURBT）术后序贯放化疗治疗对老年肌层浸润性膀胱癌（muscular invasive bladder cancer,MIBC）患者生存时间及生活质量的影响。方法:回顾性分析我院2012年03月至2016年12月收治老年MIBC患者共68例临床资料,其中38例采用膀胱根治切除方案设为对照组,30例采用TURBT术后序贯放化疗方案设为观察组;比较两组总生存时间、肿瘤特异性生存时间及手术前后QOL评分。结果:入选患者随访14~58个月,中位随访时间为37.0个月;其中观察组总生存率和肿瘤特异性生存率分别为66.67%（20/30）,80.00%（24/30）;对照组总生存率和肿瘤特异性生存率分别为65.79%（25/38）,81.58%（31/38）;两组总生存率和肿瘤特异性生存率比较差异无统计学意义（P＞0.05）;两组术后6个月QOL评分显著低于术前（P＜0.05）;但观察组术后6个月QOL评分显著高于对照组（P＜0.05）。结论:老年MIBC患者采用TURBT术后序贯放化疗方案可获得与膀胱根治切除方案相近的生存获益,且术后生活质量显著改善。     

乳腺癌患者术后生活质量影响因素的探讨

目的研究乳腺癌患者术后生活质量（QOL）情况并分析其影响因素,以探讨提高患者生活质量的干预措施。方法采用乳腺癌生命质量测评表（FACT—B,包括身体状况、社会／家庭状况、情绪状况、功能状况和特异因素方面）,对155例乳腺癌患者术后3个月、6个月、1年、2年、3年和5年的情况进行调查。对影响生活质量的因素：年龄、文化程度、婚姻状态、费用支付方式、疾病分期和术后时间6个变量进行单因素分析;再以生活质量的得分为因变量,以单因素分析结果中P〈0．050者为自变量（包括年龄、疾病分期、术后时间）,进行多重线性回归分析。结果单因素分析结果显示,不同年龄、不同疾病分期、不同术后时间的患者间生活质量的差异均有统计学意义（P〈0．050）;多重线性回归分析发现：疾病分期为中期者得分低于早期者（P=0．014）,术后时间为12个月、60个月者得分高于术后时间3个月者（P值均〈0．050）。结论疾病分期、术后时间是QOL的影响因素;应从影响因素出发,积极开展乳腺癌普查、躯体功能锻炼及心理疏导等有效的干预措施．提高患者的生活质量。     

早期非小细胞肺癌胸腔镜手术与小切口肺切除术后患者生活质量的对比研究

背景与目的:电视辅助胸腔镜手术(video-assisted thoracoscopic surgery,VATS)肺叶切除治疗临床早期非小细胞肺癌(non-small cell lung cancer,NSCLC)术后患者生活质量的系统研究很少.本研究希望通过对比胸腔镜手术与小切口开胸(minimal incision thoracotomy,MIT)肺切除治疗临床早期NSCLC,比较两种术式术后患者生活质量,探讨胸腔镜肺切除术后患者生活质量变化的特点.方法:本研究为前瞻性随机对照研究.从2004年3月至2005年3月CT提示临床早期NSCLC,且肿块直径≤6 cm的患者32例,将其随机分为VATS组(n=17)和MIT组(n=15)两组分别进行手术,VATS组有2例患者因术中不能控制的出血和胸膜广泛粘连转为开胸手术而被剔除.利用肺癌症状量表(Lung Cancer Symptom Scale,LCSS)评估术前和术后第1、3、6个月两组患者的生活质量.结果:两组患者在年龄、性别、肿瘤病理分期、肿瘤直径和术后并发症等方面差异无统计学意义.术后第1个月气促评分(VATS vs.MIT:10.9±7.4 vs.17.4±9.6),疼痛评分(VATS vs.MIT:13.7±9.5vs.23.0±12.2),两组比较差异有统计学意义(P分别为0.047、0.028);其余症状评分两组比较,差异无统计学意义(P＞0.05).肺切除术后VATS组患者症状变化为:第1个月5个主要临床症状(食欲、疲劳、咳嗽、气促和疼痛)均恶化,其中食欲、疲劳和咳嗽与术前相比差异有统计学意义(P＜0.05),术后第3个月症状逐渐恢复,除食欲外逐渐恢复至接近术前水平(P＞0.05),术后第6个月均恢复至术前水平(P＞0.05).结论:对比小切口肺切除,VATS肺切除术后患者具有更高的生活质量,其生活质量恢复的时间需要6个月.     

WBRT对肺癌脑转移者认知功能及生活质量影响前瞻性研究

目的 评估WBRT对肺癌脑转移患者认知功能及生活质量的影响。方法 以 2015年收治的 41例行WBRT的肺癌脑转移患者为研究对象,以蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)为认知评估工具,以阿尔茨海默病协作研究日常能力量表(ADCS-ADL)为生活质量评估工具。独立样本t检验WBRT前后认知功能和生活质量水平。结果 WBRT前与后经MoCA、MMSE评估认知功能障碍比例分别为96.55%、48.28%和94.29%、31.43%。WBRT前与后相比MoCA、MMSE各量表总分分别为 18.24±0.95与 19.37±0.70(P=0.341),23.51±0.88与 24.54±0.71(P=0.375)。WBRT前与后ADCS-ADL得分分别为 57.44±2.59、59.37±2.27(P=0.583)。结论 WBRT对肺癌脑转移患者总体认知功能及日常生活质量水平无明显影响。MoCA对脑转移癌患者认知功能障碍筛查时较MMSE具有更高敏感性。     

Endoscopic laser ablation as palliative treatment of endobronchial, nonresectable, or recurrent lung cancer: assessment of its impact on quality of life

Laser ablation (LA) is currently used in our institute as palliative treatment for endobronchial nonresectable or recurrent lung cancer. The objective of this study was to assess the impact of LA on the quality of life (QOL) in a large group of patients with endobronchial obstructions due to nonresectable or re-current lung cancer. Evaluation was based on Eastern Cooperative Oncology Group performance status (ECOG PS) for the "objective" assessment of QOL and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 version 1.0 (EORTC QLQ-C30(v1)) for the "subjective" assessment of QOL. From May 1994 to June 1997, 133 LAs were performed using neodymium: yttrium-aluminum garnet (Nd:YAG) laser at low power settings (< 30W) on 89 evaluable patients (Male/Female 78/11, mean age 63.5/62.8 years, range 42-82/47-73). The QOL was evaluated by ECOG PS and QLQ-C30(v1) at baseline (3 days before LA), t1 (7 days after LA), and t2 (1 month after LA). The objective tumor response was evaluated at t2. The objective tumor response to LA intervention was "excellent," ie, complete response (CR), in 33 (24.8%) patients and "fair," ie, partial response (PR), in 97 (72.9%) patients, with an overall response rate (ORR) of 97.7%. A highly significant decrease in high score (ECOG PS 3-4) was registered from baseline to t1 and from t1 to t2. However, at the same time a significant increase of low score (ECOG PS 0-2) was observed. The comparison of patient QOL assessment by QLQ-C30(v1) at different times during the study was also made; the functioning scales, the global QOL scale, and the symptom scales/items showed a highly significant improvement at t1 compared to baseline (P < 0.001), whereas only global QOL improved at t2 compared to t1. A comparison of baseline ECOG PS scale with QLQ-C30(v1) scale revealed a strong relationship between PS and the symptom "fatigue." Our study demonstrates that dramatic clinical improvement obtained by an effective though palliative treatment such as LA improves QOL based on both physician-rated (PS) and mostly self-rated (QLQ-C30(v1)) assessment.     

原发性大肝癌患者术后生存质量的调查研究

目的:研究原发性大肝癌患者术后的生存质量。方法:以我院收治的70例原发性大肝癌患者作为研究对象,对70例大肝癌患者分别在手术前、手术后1个月、手术后3个月进行自身调查,采用肝癌患者生活质量测定量表和Piper疲乏修正量表。结果:手术后1个月、3个月分别与手术前相比,患者生存质量的四个维度、QOL评分总分以及自评总分均较前提高,Piper疲乏修正量表评分四个维度均较前降低,P值均<0.05,差异有统计学意义。术后3个月和术后1个月比较,生存质量的四个维度以及QOL评分总分均有所提高,Piper疲乏修正量表评分四个维度均有所降低,P值均<0.05,差异有统计学意义,自评总分无明显差异。患者手术后1个月生存质量维度等级分类与治疗前相比有明显差异,8~10分的比例明显提高,0~3分的比例减少,P值均<0.05,差异有统计学意义。结论:原发性大肝癌患者经过手术治疗以后能够改善患者的生存质量。在临床护理中,有必要对患者术前、术后的生存质量进行评定,通过评价的结果采取有针对性的护理干预,有助于提高大肝癌患者的生存质量。     

盐城地区食管癌化疗患者近期生命质量评价

目的：通过对盐城地区中晚期食管癌化疗患者近期生命质量（QOL）进行评价,指导临床化疗方案的选择及提高患者生命质量。方法：收集2013-2014年49例原发性食管癌新发病例在化疗前1 d、化疗后1周、化疗后4周的人口学资料、疾病与治疗情况、生命质量测量量表,运用癌症患者生命质量核心量表（EORTC QLQ-C30）按5个功能领域、3个症状领域、6个单项测量条目及1个总体健康状况领域将生命质量测量分值进行标准化换算。对人口学资料及疾病特征、患者化疗前后QOL的变化、影响化疗患者QOL的因素采用SPSS 17.0软件进行统计描述和分析。结果：化疗后1周较化疗前1 d功能领域有所改善,但恶心呕吐、疼痛、失眠、腹泻症状及经济困难加重（P < 0.05）;化疗后4周较化疗前1 d除社会支持功能外,功能领域得分变高,躯体症状加重（P < 0.05）;化疗后4周较化疗后1周躯体、角色、总体功能改善（P < 0.05）,但恶心呕吐、食欲丧失、腹泻仍有加重现象（P < 0.05）。QOL与年龄、文化程度、居住地、临床分期、不同淋巴转移结局有关。结论：化疗患者生命质量受化疗时间、年龄和文化程度等相关因素的影响,需通过选择个性化方案、采取综合措施来提高。     

Quality of life as a survival predictor for esophageal squamous cell carcinoma treated with radiotherapy

PURPOSE: Accumulating reports suggest that quality of life (QOL) may predict survival in cancer patients. In this study, we longitudinally investigated whether the QOL data assessed before, during, and after treatment are prognostic for the survival of patients with esophageal squamous cell carcinoma treated with primary radiotherapy (RT). METHODS AND MATERIALS: A total of 110 consecutive new esophageal squamous cell carcinoma patients treated with primary RT were studied. The European Organization for the Research and Treatment of Cancer questionnaire QLQ-C30 (in the Taiwan Chinese version) plus the scales concerning dysphagia and odynophagia were completed before, during, and 2 months after RT. Cox proportional hazards models were used to analyze the impact of clinical and QOL variables on survival. RESULTS: A clinical model that included clinical and sociodemographic variables to predict survival using multivariate analysis revealed weight loss, American Joint Committee on Cancer stage, and radiation dose to be statistically significant survival predictors. For QOL scores before RT, physical functioning was the most significant survival predictor. The 2-year survival rate was 30% for patients with a physical functioning score of > or =80.0 compared with a survival rate of 20% for those with a score of <80.0. The QOL scores during RT did not significantly correlate with survival. Of the QOL scores 2 months after RT, the dysphagia symptom scale was the most significant survival predictor. Improvement in dysphagia was observed in 43.0% of patients during RT and in 48.4% of patients 2 months after RT. A dysphagia-free status was found in 35.5% of patients 2 months after RT. The 2-year survival rate was 54.5% for patients without dysphagia 2 months after RT compared with 14.3% for those with dysphagia (p <0.001). CONCLUSION: The data provide evidence to support the correlation of patient-reported QOL scores with survival. Pretreatment physical functioning might be a surrogate marker of an unrecognized biologic prognostic factor. The poor survival outcome for patients with persistent dysphagia after treatment implies that local control remains the main issue to overcome in treating esophageal cancer with RT.