Dosimetric Evaluation of Cardiac Substructures in Irradiation of Esophagus

We found that despite all the treatment plans meeting the whole heart V45 and V40 constraints, none of the cases met the dose constraints to all cardiac substructures. This suggests that dosimetric evaluation of the whole heart alone may not be sufficient in minimizing cardiac toxicities from RT, and thus further supports the importance of defining the cardiac substructures. Future studies will be needed to standardize the dose constraints to these substructures to ensure patient safety.