Effect of structured nursing care on treatment tolerance and quality of life in patients with esophageal cancer undergoing radiotherapy: a retrospective cohort study.

Objective: To evaluate the relationship between structured nursing care (SNC) and treatment tolerance in patients with esophageal cancer receiving radiotherapy (RT). Methods: This single-center retrospective cohort analysis included 120 patients with esophageal cancer who received definitive or adjuvant RT from January 2020 to December 2024. Patients received either standard nursing care (standard care) or SNC. The primary outcome was RT completion. Secondary outcomes included grade ≥2 toxicity, unplanned hospitalizations, weight change, and quality of life (QoL) as measured by the EORTC QLQ-C30 and QLQ-OES18. Multivariable logistic regression was performed to adjust for prespecified covariates. Results: The SNC group had a higher percentage of patients completing RT compared with the standard care group (89.5% vs 79.4%, p = 0.14). The incidence of grade ≥2 toxicity was lower in the SNC group (33.3% vs 50.8%, p = 0.048). Unplanned hospitalizations were also lower in the SNC group (7.0% vs 17.5%, p = 0.08). Weight loss was less pronounced in the SNC group (-1.7 ± 1.9 kg vs -2.8 ± 1.9 kg, p = 0.02). Descriptive QoL change data showed directionally more favorable patterns in the SNC group compared with the standard care group. In the adjusted analyses, SNC was associated with a higher odds of RT completion, but that association did not reach statistical significance (OR 2.09, 95% CI 0.69-6.30; p = 0.1899). Conclusion: SNC was associated with directional trends favoring treatment tolerance outcomes, although the adjusted association with completion of RT was not statistically significant. Therefore, these findings are exploratory in nature and warrant additional prospective studies evaluating structured supportive models of care.