Abstract: Objective To explore the clinical effect of whey protein and vitamin D combined with anti-resistance exercise in improving sarcopenia in elderly patients with esophageal cancer.Methods Retrospective analysis of clinical data from 76 patients with esophageal cancer and sarcopenia treated at Yancheng Third People's Hospital between June 2023 and August 2024 was conducted.The patients were divided into a control group (38 cases) and an observation group (38 cases) based on different nutritional support regimens.The control group received conventional nutritional support,while the observation group was subjected to a combined intervention of whey protein,vitamin D,and resistance exercise.The nutritional status of patients in the two groups was assessed using the patient Subjective Global Assessment Scale (PG-SGA),the quality of life of patients in the two groups was assessed using the esophageal cancer Specific Scale (QLQ-OES18),and the levels of serum albumen(ALB),hemoglobin(Hb) and C-reactive protein(CRP),skeletal muscle mass index,grip strength and walking speed were compared between the two groups.And complication rates in both groups.Results Three month after operation,the PG-SGA score of the observation group was 11.54±2.03,which was significantly lower than that of the control group （13.11±1.97）(P<0.05).The QLQ-OES18 scale showed that the scores of swallowing function in the observation group (67.43±4.89) were significantly higher than those in the control group(64.69±4.26)(P<0.05),while the scores of eating discomfort,pain and reflux (56.47±4.69,57.28±5.18 and 54.94±4.87) were significantly lower than those in the control group（59.51±4.75,60.44±5.05,57.29±5.03） (P<0.05).In addition,the plasma ALB and Hb of the observation group were （42.26±2.99）g/L and（127.53±10.11）g/L,respectively,which were significantly higher than those of the control group[（34.09±4.61）g/L and（112.81±15.87）g/L] (P<0.05),and the CRP was （7.67±2.93）mg/L,which was significantly lower than that of the control group[（12.78±3.14）mg/L] (P<0.05).The skeletal muscle mass index,grip strength and walking speed of observation group were（6.35±0.92）kg/m

Key words: whey protein, vitamin D, resistance movement, esophageal cancer, sarcopenia