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TnT levels increased in 15 patients (88%) in the high-dose group and remained stable in the other 2 patients. In the low-dose group, TnT levels did not change during CRT except for 2 patients with cardiac abnormalities (1 with cardiomyopathy and the other with left bundle branch block). The ratio of TnT during CRT/before CRT was highly correlated with mean heart dose at the time of sample collection (Spearman's rhoZ0.39, PZ0.004). Furthermore, mean heart dose was the only factor associated with the slope change in TnT during CRT (regression coefficient: 0.41, 95% confidence interval [CI] 0.12À0.69, PZ0.007). Receipt of induction chemotherapy may have association with TnT increase during CRT as well (coefficientZ0.24, 95% CI À0.04 to 0.52, PZ0.085). Conclusion: TnT levels during definitive CRT were strongly related to mean heart dose, although we cannot rule out individual differences in TnT response to cardiac irradiation. Early monitoring of TnT may help clinicians identify patients who are more sensitive to cardiac damage from radiation and to tailor treatment accordingly. We are currently expanding this analysis to include the 274 patients enrolled in this trial.