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Nadia Veilleux, Philippe Goffaux, Marie Boudrias, David Mathieu, Kathya Daigle, and David Fortin

importance of QOL for terminally ill patients. 14 Quality of life is a complex and multifaceted concept, often tainted by personal experience and social issues. Although some concerns regarding QOL appear to be universal (for example, emotional distress and/or impaired functional status), many others are uniquely determined, and depend on the presence of factors that may initially appear unrelated to the disease process. One such factor is chronological age (ascertained at evaluation), which is often recognized as an important component of the way patients interpret and

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Simone A. Betchen, Jane Walsh, and Kalmon D. Post

function. Headache had the clearest trend and was only statistically significant in two categories, despite the fact that these are the issues that affected peoples' return to work and their outlook on the surgery. This is clinically important when discussing with patients the options currently available: surgery compared with radiation or serial imaging studies. Although all the options are not appropriate in many situations, the QOL after surgery should be taken into consideration. Abbreviations used in this paper QOL = quality of life ; SDS

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Daniel Lubelski, Nilgun Senol, Michael P. Silverstein, Matthew D. Alvin, Edward C. Benzel, Thomas E. Mroz, and Richard Schlenk

quantify quality of life (QOL) outcomes after primary compared with revision discectomy. We therefore investigated QOL outcomes after primary and revision discectomy (i.e., 2-time herniation) by using validated health status measures: EQ-5D, the Patient Health Questionnaire–9 (PHQ-9), and the Pain and Disability Questionnaire (PDQ). Our hypothesis was that QOL would improve for all patients after primary and revision discectomy but that the improvements would be reduced after revision surgery. Methods We retrospectively reviewed records of all patients who had

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Adomas Bunevicius, Karen Lavezzo, Leah Shabo, Jesse McClure, and Jason P. Sheehan

metastatic deposits. 4 Ionizing radiation plays a central role in the management of intracranial metastases. 5 , 6 Stereotactic radiosurgery (SRS) allows precise delivery of radiation to treat intracranial lesions for durable local control, and it is therefore considered a standard of care for brain metastases. 7 , 8 SRS can be associated with better preservation of cognitive functioning and quality of life (QOL) when compared with whole-brain radiation therapy (WBRT). 9–11 Preservation of cognitive functioning is important for maintaining QOL of long-term cancer

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Marc S. Schwartz, Seth A. Riddle, Johnny B. Delashaw Jr., Michael A. Horgan, Jordi X. Kellogg, and Sean O. McMenomey

In the treatment of acoustic neuroma, operative results have improved greatly during recent years, with high rates of functional cranial nerve preservation. Because of this, it has become more important to consider issues of patient satisfaction and quality of life (QOL) following treatment for these lesions. The authors have developed a novel questionnaire designed to measure QOL in patients with acoustic neuromas, and they administered it to 50 consecutive patients at least 6 months after acoustic neuroma surgery. Overall QOL was judged to be good but with definite minor difficulties, including some problems with hearing, facial nerve function, headache, tinnitus, dizziness, activity level, enjoyment of life, and emotional well-being. No significant differences were found between age groups and different operative approaches, and only minor differences were found in relation to tumor size. Patients with intracanalicular tumors fared no better than those with cerebellopontine angle tumors. Analysis of the data suggests an overall good outcome from acoustic neuroma surgery; however, when discussing the possible effects on postoperative QOL, even the potential minor problems should not be minimized, especially in patients undergoing operation for small or intracanalicular tumors.

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Roberto Jose Diaz, Nicole Maggacis, Shudong Zhang, and Michael D. Cusimano

one of slow but relentless progression, often impacting neurological function, which leads to disability and ultimately death. The increasing burden of disease is thought to affect the physical, social, and mental well being of patients while increasing the demand for caregiver support. However, to our knowledge, no systematic analysis of quality of life in patients with chordoma has been previously reported. Modern therapy for chordomas is reported to have a 5-year actuarial tumor control rate between 47% and 80% following one procedure. 6 , 18 , 24 , 28 , 36

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James Feghali, Zach Pennington, Jeff Ehresman, Daniel Lubelski, Ethan Cottrill, A. Karim Ahmed, Andrew Schilling, and Daniel M. Sciubba

prognostic models have focused on the prediction of postoperative patient survival. 8–12 However, the goal of surgical intervention is often symptom palliation, not oncological cure. Tumor-related symptoms cause significant reductions in quality of life (QOL), which are measurable on standardized questionnaires as impairments in several domains such as physical function, social roles, pain, and mental health. 13 Surgery can improve health-related QOL (HRQOL) outcomes in patients with metastatic spine disease; 14–19 however, not all patients experience equivalent

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Michael A. Weitzner, Christina A. Meyers, and Kevin Byrne

O ver the past decade increasing attention has been given to the quality of life (QOL) of patients undergoing treatment for cancer. 34 Their QOL depends greatly on the alleviation of distressing physical and psychological symptoms, and they are subject to many late physical and emotional effects of the disease. Cancer patients, like others who have chronic illnesses, must deal with major disruptions of their lives and social roles, which may lead to changes in their relationships with spouses, family, and friends. 6 Because of cognitive dysfunction, the

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Joseph Bampoe, Normand Laperriere, Melania Pintilie, Jennifer Glen, Johann Micallef, and Mark Bernstein

domains  (Bergner, et al., 1981;  & Rand Corp.) * ALQI = Aachen Life Quality Inventory; BTM = Brain Tumor Module; FLIC = Functional Living Index—Cancer; FP-QLI = Ferrans and Powers Quality of Life Index; GOP = Glioma Outcomes Project; PAIS-SR = Psychosocial Adjustment to Illness Scale—Self Report. Clinical Material and Methods Patient Population The trial was designed to compare conventional external radiation therapy alone (50 Gy in 25 fractions) with conventional radiation therapy plus a brachytherapy boost (minimum peripheral tumor dose of 60 Gy to all enhancing

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Matthew J. Viereck, George M. Ghobrial, Sara Beygi, and James S. Harrop

I ntradural extramedullary spinal tumors are rare neoplasms that can cause significant pain, gait disturbances, sensory changes, and decreased longevity. While the majority of spinal tumor pathologies in the intradural extramedullary compartments of the spine are schwannomas, meningiomas, and neurofibromas, these histologically benign tumors can cause profound impairment on quality of life through pain and myeloradicular symptoms caused by direct compressive effects. Management of patients experiencing severe symptoms frequently involves tumor resection