{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:48:47Z","timestamp":1789051727799,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:00:00Z","timestamp":1770508800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2404602"],"award-info":[{"award-number":["2022YFC2404602"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dose exposure to supraventricular cardiac conduction system doses has been reported to be associated with distinct arrhythmia classes after thoracic radiotherapy, but its impact in esophageal squamous cell carcinoma (ESCC) remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Locally advanced ESCC treated with neoadjuvant chemoradiotherapy (nCRT) were included. The primary endpoint was grade \u2265\u20093 adverse cardiac arrhythmia events. Prediction performance was evaluated through time\u2010dependent receiver operating characteristic curves, and competing risk frameworks were implemented to quantify the cumulative incidence of distinct cardiac arrhythmia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 358 patients, 84.9% were men, with a median age of 66\u2009years (range: 39\u201379\u2009years). A total of 60 (16.8%) patients experienced at least 1 grade \u2265\u20093 arrhythmia, with a median time to first arrhythmia of 13\u2009months (95% CI: 12\u201315\u2009months). The 2\u2010year cumulative incidences of distinct cardiac arrhythmia were 8.89% for AF, 2.96% for atrial flutter, and 5.12% for other SVT. Baseline coronary heart disease was a risk factor for all types of arrhythmia (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). After adjusting for baseline cardiovascular risk factors, Heart\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      (sHR 3.69,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0024) was associated with AF, Heart volume receiving 5 Gy with atrial flutter (sHR: 9.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0077), and Heart volume receiving 40 Gy (sHR 5.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00078) with other SVT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Grade \u2265\u20093 cardiac arrhythmia associated with thoracic radiation occurs in 16.7% of ESCC patients undergoing nCRT within a median time of 13\u2009months. The radiation dose exposure of the supraventricular cardiac conduction system is not associated with increased cardiac arrhythmia. Specific arrhythmia subtypes exhibited differential associations with distinct dose\u2010volume parameters of whole heart irradiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71610","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T02:34:28Z","timestamp":1770604468000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Whole Heart Dose Parameters Predict Severe Arrhythmias After Neoadjuvant Chemoradiotherapy for Esophageal Squamous Cell Cancer: A Competing Risk Analysis of 358 Patients"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5484-3343","authenticated-orcid":false,"given":"Wei\u2010Xiang","family":"Qi","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Ruijin Hospital Shanghai Jiaotong University School of Medicine  Shanghai China"},{"name":"Shanghai Key Laboratory of Proton\u2010Therapy  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