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目的:研究老年营养风险指数(GNRI)与接受根治性放疗或放化疗的老年食管癌患者预后间的关系。方法:回顾性分析河北医科大学第四医院2007年1月至2013年12月197例接受根治性放疗或放化疗且年龄≥75岁的食管鳞癌患者的临床资料，计算患者放疗前后老年营养风险指数(GNRI)、体质量指数(BMI)并进行分组。Kaplan-Meier法对生存时间行单因素预后分析，Cox回归模型行多因素预后分析。结果:放疗前GNRI评分正常组139例，异常组58例，两组5年生存率及无进展生存率分别为11.08%、9.82%和8.73%、6.18%(n P>0.05)。放疗后GNRI评分正常组68例，异常组129例，5年生存率及无进展生存率分别为17.04%、7.42%和16.17%、3.65%(χn 2＝12.316、14.617，n P0.05). There were 68 patients in the normal GNRI group and 129 patients in the abnormal GNRI group after radiotherapy. The 5-year OS rates and PFS rates in the normal and abnormal GNRI groups were 17.04%, 7.42% and 16.17%, 3.65%, respectively, with statistically significant difference (n χ2=12.316, 14.617, n P<0.05). Univariate analysis showed that T stage, N stage, TNM stage, GTV, NLR before radiotherapy, BMI after radiotherapy, hemoglobin level after radiotherapy and GNRI after radiotherapy were significantly correlated with OS (n χ2=6.569-22.434, n P<0.05). And T stage, GTV, NLR before radiotherapy, BMI after radiotherapy, hemoglobin level after radiotherapy and GNRI after radiotherapy were significantly correlated with PFS (n χ2=4.579-18.990, n P<0.05). Multivariate analysis showed that T stage, N stage, NLR before radiotherapy, hemoglobin level after radiotherapy and GNRI after radiotherapy were independent factors for OS (n P<0.05). And NLR before radiotherapy, hemoglobin level after radiotherapy and GNRI after radiotherapy were independent factors for PFS (n P<0.05). Multivariate analysis showed that T stage, hemoglobin level after radiotherapy and GNRI after radiotherapy were independent factors for short-term effects (χn 2=4.716, 13.083, 4.519, n P<0.05).n Conclusions:The GNRI after radiotherapy can be used as a useful indicator for predicting survival in elderly patients with ESCC receiving radiotherapy or radiochemotherapy. Nutritional intervention should be carried out for elderly patients of abnormal GNRI with ESCC to improve survival.