The aim is to evaluate the physical dose distributions in esophageal carcinoma implanted with permanent cardiac pacemaker treated with non-coplanar intensity modulated radiation therapy (no-co-IMRT). Eight patients with esophageal carcinoma implanted cardiac pacemaker proven by histology were treated by IMRT. For each patient, we designed two IMRT plans by Eclipse IMRT inverse plan system: non-coplanar IMRT plan (3 coplanar fields and 2 non-coplanar fields) and coplanar IMRT plan (5 coplanar fields). The same physical parameter was applied to the same patient in both plans. Plans were evaluated in terms of dose-volume histogram, conformity index, homogeneity index, monitor unit and control points. The results showed that no-co-IMRT plan could significantly reduce the max dose of implantable cardiac pacemaker and the wires (p<0.05), but no significant difference was found between no-co-IMRT plan and co-IMRT plan in target volume and other normal tissues. Compared with co-IMRT plan, the monitor unit (MU) and control points of no-co-IMRT plan were not increased significantly (p>0.05). These findings indicate that the technique of no-co-IMRT can obtain the fewer max dose of implantable cardiac pacemaker and the wires during intensity modulated radiation therapy of esophageal carcinoma.Cited