الفهرس 
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Abstract
This is a prospective study included 120 patients with pelvic malignancies including bladder, rectum, cervix, endometrium and prostate, who received radical radiotherapy with or without chemotherapy or hormonal treatment.
The included patients were divided into two groups, intervention group (with immunenutrition added with planned diet), and standared group with standared diet only.
In this study, we have investigated the effect of immune nutritional supplements during radiotherapy to pelvic organs with or without chemotherapy or hormonal treatment and found that:
There was no difference between both groups regarding demographics, clinical, pathological data and treatment modalities at the beginning of the study.
There was significant difference between both groups regarding percentage of weight gain which was higher in intervention group (p. less than 0.0001), non-obese patients in intervention group increased in post treatment weight and BMI which were statistically significant (P=0.001, < 0.0001) respectively.
There was significant difference between both groups regarding percentage of weight loss (P< 0.0001).
Non obese patients in standared group decreased in weight and BMI that were significant (P<0.0001, < 0.0001) respectively. Obese patients in intervention group decreased in post treatment weight and BMI which were non-statistically significant (P =0.086, 0.062) respectively, also obese patients in standared group decreased in weight and BMI that were non-significant (P= 0.229, 0.140) respectively. There was statistically significant difference between both groups regarding incidence of toxicity, which was lower in intervention group (P= 0.022). Although there was no significant difference in grade and type of toxicity between both groups; intervention group had lower grade 2 and 3 toxicity. There was significant difference regarding time to recovery from toxicity in days, intervention group had lower time than standared group (6 days VS 13 days) (P= 0.001). Significant higher number of patient hospitalized due to toxicity in standared group than intervention group (P=0.021). Supplements with arginine, glutamine and fish oil during course of radiotherapy could decrease treatment interruption and decrease over all treatment time (p= 0.022, 0.369) respectively. Although there was no significant difference between both groups regarding respose to antineoplastic treatment; higher CR rates were found in intervention group (P= 0.213) By univariate logistic regression of risk factors, it was found that diagnosis as cancer bladder and rectum (*P<0.001, P=0.002) respectively had high risk of toxicity development, and the factors associated with significant lower toxicity were immunenutrition group (*P=0.024) and adherence to immune nutrition (*P=0.011). By multivariate analysis, it was found that intervention group, diagnosis as bladder cancer and diagnosis as rectal cancer (P0.045, P0.026, P0.001) were the independent predicator for incidence of toxicity.