{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:23:54Z","timestamp":1790328234666,"version":"4.1.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007210","name":"RWTH Aachen University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007210","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Radiotherapy is one of the main treatment options for patients with esophageal cancer; however, it has been linked with an increased risk of cardiac toxicities. In the current study, we evaluated the effect of planning the radiation in deep-inspiration breath hold (DIBH) on the dose sparing of cardiac substructures and lung.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>In this study, we analyzed 30\u00a0radiation therapy plans from 15\u00a0patients diagnosed with esophageal cancer planned for neoadjuvant radiotherapy. Radiation plans were generated for 41.4\u202fGy and delivered in 1.8\u202fGy per fraction for free-breathing (FB) and DIBH techniques. We then conducted a\u00a0comparative dosimetric analysis, evaluating target volume coverage, the impact on cardiac substructures, and lung doses across the two planning techniques for each patient.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There was no significant disparity in target volume dose coverage between DIBH and FB plans. However, the D<jats:sub>mean<\/jats:sub>, D2%, and V30% of the heart experienced substantial reductions in DIBH relative to FB, with values of 6.21 versus 7.02\u202fGy (<jats:italic>p<\/jats:italic>\u202f=\u20090.011), 35.28 versus 35.84\u202fGy (<jats:italic>p<\/jats:italic>\u202f=\u20090.047), and 5% versus 5.8% (<jats:italic>p<\/jats:italic>\u202f=\u20090.048), respectively. The D<jats:sub>mean<\/jats:sub> of the left ventricle was notably lower in DIBH compared to FB (4.27 vs. 5.12\u202fGy, <jats:italic>p<\/jats:italic>\u202f=\u20090.0018), accompanied by significant improvements in V10. Additionally, the D<jats:sub>mean<\/jats:sub> and D2% of the left coronary artery, as well as the D2% of the right coronary artery, were significantly lower in DIBH. The dosimetric impact of DIBH on cardiac substructures proved more advantageous for middle esophageal (ME) than distal esophageal (DE) tumors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Radiotherapy in DIBH could provide a\u00a0method to reduce the radiation dose to the left ventricle and coronaries, which could reduce the cardiac toxicity of the modality.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-024-02197-8","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T14:02:41Z","timestamp":1707141761000},"page":"624-632","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Dosimetric advantages for cardiac substructures in radiotherapy of esophageal cancer in deep-inspiration breath hold"],"prefix":"10.1007","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0978-1996","authenticated-orcid":false,"given":"Ahmed Allam","family":"Mohamed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melina Nausikaa","family":"Douglas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Bruners","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Eble","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"2197_CR1","unstructured":"Survival Rates for Esophageal Cancer | Esophageal Cancer Outlook. https:\/\/www.cancer.org\/cancer\/esophagus-cancer\/detection-diagnosis-staging\/survival-rates.html#references. 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