Abstract: Objective To compare the survival and toxicities of concurrent chemoradiotherapy or radiotherapy alone in patients with N1 esophageal carcinoma. Methods From August 2002 to August 2005， 130 eligible patients with N1 esophageal carcinoma were randomly divided into the following groups: sixty-five patients for concurrent chemoradiotherapy group， sixty-five patients for radiotherapy alone. The schedules of radiotherapy were the same， with 3-DCRT with conventional fractionation ， total dose 64～66Gy. The regiment of chemotherapy were all consisted of NDP and 5-Fu， 4 cycles . Results The survival rates at 1-、2- and 3-years were 72.3%，55.3% and 40% in the concurrent chemoradiotherapy group,while the numbers were 75.3%，38.5% and 18.5% in the radiotherapy alone group (P =0.007).The patients in concurrent chemoradiotherapy group who completed 1~2 cycles and 3~ 4 cycles the survival rates at 1-,2- and 3-years were 70%,53.3%,30% and 74.2%,57.1%,48.6% (P=0.128),respectively; 3-year distant metastasis rates were 10.7% in concurrent chemoradiotherapy group， and 16.9% in radiotherapy alone group (P＝0.31)，respectively.Acute toxicity in concurrent chemoradiotherapy group was higher than radiotherapy alone group，and later toxicity were similar in two group. Conclusion Concurrent chemoradiotherapy increased severity acute toxicity， and could increase survival rate compared with radiotherapy alone in patient with N1 esophageal carcinoma， and the patients who completed 3~4 cycles seemed better than those completed 1~2 cycles.