Abstract
BACKGROUND AND AIMS: Esophageal squamous cell carcinoma (ESCC) is commonly associated with high rates of malnutrition, adversely affecting patient outcomes. This study aims to assess the impact of nutritional support combined with concurrent chemoradiotherapy (CCRT) on survival and prognosis in ESCC patients, utilizing prognostic models based on five key immunonutritional indicators. METHODS: In this retrospective study, we reviewed the medical records of 200 esophageal squamous cell carcinoma patients who were treated between January 2017 and June 2022. Patients were categorized into two groups based on their treatment records: one group received nutritional support in addition to standard CCRT, and the other received only CCRT. We retrospectively analyzed survival outcomes using Kaplan-Meier curves and log-rank tests, and identified independent prognostic factors through Cox proportional hazards models. The study further assessed five specific immunonutritional indicators to develop and validate predictive nomogram models. The effectiveness of these models was evaluated using receiver operating characteristic (ROC) curve analysis to determine their predictive accuracy for patient outcomes. RESULTS: Nutritional support improved overall survival (OS) and progression-free survival (PFS) compared to the non-nutritional group. Patients in the nutritional group showed better biochemical markers and quality of life with fewer treatment-related complications. The nomogram models based on the immunonutritional indicators demonstrated strong predictive accuracy for both OS and PFS, with LMY and PAR showing the highest prognostic power. CONCLUSIONS: Integrating nutritional support into the treatment plan for ESCC patients undergoing CCRT enhances may enhance treatment tolerance, reduce toxicity, and indirectly contribute to improved survival rates, quality of life, and fewer complications. The five immunonutritional indicators provide robust predictive capabilities for patient outcomes, supporting the use of personalized nutritional interventions and nomogram models in clinical practice.