13 General introduction Chapter 5 and 6 describe the results of a cross-sectional prospective study among esophageal cancer survivors treated with neoadjuvant chemoradiotherapy plus surgery versus patients treated with surgery only. We performed several diagnostic tests to objectify clinical as well as subclinical damage that might be caused by the chemoradiation in these so-called survivors. In chapter 5 we focused more specifically on changes seen on MRI, quantified these findings and related them to the spatial dose distribution as given during the neoadjuvant chemoradiotherapy. In chapter 6 we combined the results of the different imaging techniques, ECG, biomarkers and functional assessments versus clinical events and dose distributions. Chapter 7 reports on a longitudinal prospective study monitoring cardiac blood biomarkers during and after radiotherapy for esophageal cancer. We hypothesized that these parameters would be useful in future clinical practice and/or trials to predict radiation induced cardiac toxicity. We analyzed relationships with cardiac and pulmonary radiation dose volume parameters and clinical events of both organs at risk. In chapter 8 we conclude by summarizing the results and discuss future perspectives 1
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