Objective To analyze the clinical parameters of esophageal cancer patients before and during neoadjuvant chemotherapy,as well as to explore the related factors and predictive value that affect the efficacy of neoadjuvant chemotherapy for esophageal cancer.Methods A total of 194 patients with esophageal cancer who underwent neoadjuvant chemotherapy at the First Affiliated Hospital of Guangxi Medical University from 2020 to 2023 were selected as the research subjects.The treatment process and outcomes of the patients were followed up,and they were divided into an effective group and an ineffective group according to the effi-cacy.Differences were compared in clinical parameters between two groups of patients before and during treat-ment,screen for factors that may affect efficacy,correlation analysis was conduct to explore the correlation be-tween relevant factors and the efficacy of neoadjuvant chemotherapy,and the predictive value of relevant fac-tors were analyzed using receiver operating characteristic(ROC)curve analysis.Results There was a statisti-cally significant difference(P＜0.05)in the average cycle cost,lowest WBC value,lowest PLT value,inci-dence of nausea,transaminase abnormalities,and hair loss between the two groups.Logistic regression analysis showed that average cycle cost,transaminase abnormalities,and hair loss were related factors affecting neoad-juvant chemotherapy for esophageal cancer.Spearman correlation analysis showed that the above indicators had a certain correlation with the efficacy of neoadjuvant chemotherapy for esophageal cancer.ROC curve a-nalysis showed that the area under the curve(AUC)for predicting the efficacy of neoadjuvant chemotherapy in esophageal cancer by combining transaminase abnormalities,average cycle cost,and hair loss was 0.758(95％CI:0.683-0.832)Conclusion There is a certain correlation between average cycle cost,transaminase abnormalities,and hair loss and the effectiveness of neoadjuvant chemotherapy for esophageal cancer,which has certain predictive value for the efficacy of neoadjuvant chemotherapy for esophageal cancer.