ArticleFrontiers in nutrition2026
Prognostic impact of low BMI on outcomes following definitive radiotherapy for esophageal squamous cell carcinoma.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Esophageal squamous cell carcinoma (ESCC) is a globally significant malignancy with a poor prognosis. While definitive radiotherapy is a primary curative-intent treatment for early-to-mid-stage ESCC, patient outcomes remain heterogeneous. Nutritional status, as reflected by body mass index (BMI), is increasingly recognized as a critical host-related factor influencing cancer prognosis. However, evidence regarding the impact of low BMI on survival and treatment-related toxicity in ESCC patients treated with radiotherapy remains limited. Methods: This retrospective, single-center cohort study analyzed 135 patients with stage I-III ESCC who received definitive radiotherapy between 2021 and 2024. Patients were stratified into low BMI (<18.5 kg/m Results: The low BMI group had a significantly higher proportion of advanced TNM stage III disease (78.8% vs. 49.0%, Conclusion: Low baseline body mass index (BMI) was associated with inferior unadjusted overall survival and a numerically higher burden of treatment-related toxicity in ESCC patients undergoing definitive radiotherapy. However, after accounting for TNM stage and NRS2002-defined nutritional risk, BMI did not remain an independent prognostic factor. These findings suggest that BMI should be interpreted as a simple surrogate marker of nutritional vulnerability and adverse baseline clinical status. Comprehensive nutritional assessment and early supportive intervention should be integrated into multidisciplinary management for this vulnerable population.
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