Abstract
Purpose: To determine the pharmacological implications of nutritional intervention and the occurrence of toxic side effects in patients with locally advanced esophageal cancer undergoing concurrent chemoradiotherapy.
 Methods: An extensive retrospective analysis of clinical data was carried out on individuals who received concurrent chemo-radiotherapy. 150 patients were included in the study, with 85 patients receiving nutritional management (intervention group) and 65 patients without nutritional support (control group). Assessments were conducted for Nutritional Risk Screening-2002 (NRS-2002) and patient-generated subjective global assessment (PG- SGA) scores, serum nutritional parameters, toxic side effects and treatment completion rates at 2, 4, and 6 weeks before and during chemo-radiotherapy.
 Results: After concurrent chemo-radiotherapy, intervention group exhibited significantly lower NRS2002 and PG- SGA scores compared to control group (p = 0.002 and 0.001, respectively). Intervention group had a statistically significant increase in PALB (p = 0.001) and ALB, while control group experienced a significant decline in ALB (albumin) and PALB (pre-albumin) levels. Grip strength also significantly decreased in control group compared to intervention group (p = 0.003). Intervention group showed a significantly lower incidence of radiation esophagitis. Moreover, a smaller proportion of patients in intervention group experienced interruptions or delays in radiotherapy compared to control group (95 % vs. 83.3 %).
 Conclusion: Nutritional intervention has a pharmacological impact on maintaining nutritional status, reducing treatment toxicities and improving the completion rates of chemo- radiotherapy in patients with locally advanced esophageal cancer. Further investigations and longer-term studies are warranted to shed more light on the potential impact of nutritional interventions on the overall survival rates of these patients
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