Abstract: Objective To explore the clinical value of intensity modulated radiation therapy（IMRT）combined with PF chemotherapy for medium and late stage esophageal cancer. Methods Seventy-seven patients with medium and late stage esophageal cancer patients were randomly divided into two groups.37 patients in Group A were treated with intensity modulated radiation therapy plus PF chemotherapy.Forty patients in Group B were treated with conventional radiotherapy plus PF chemotherapy.Both group A and group B received the chemotherapy of PF regimen.All patients received DDP 30 mg/(m2·day)，5-Fu 0.5 g/(m2·day) in the first and fifth week of radiotherapy by Intravenous infusion 3 days. Radiotherapy didn't stop. Radiation dose for all patients were DT66Gy, 6 ~ 7 weeks to complete. Results The overall response rate(CR+PR) was 89.2% in Group A,but 65% in Group B.The χ² value is 7.18 and P<0.05.The 1-year,2-year and 3-year survival rate was 83%,65% and 51% respectively,in Group A. And 72%,53% and 32%,respectively, in Group B.There were significantly statistical difference between two groups(χ²=5.53,P<0.05).Acute radiation-induced esophagitis were not statistical different between two groups(χ²=0.08,P>0.05).The acute radiation-induced pulmonitis in Group A was significantly higher than that in Group B(χ²=8.99,P<0.01). Conclusion Intensity modulated radiation therapy(IMRT）combined with chemotherapy for the treatment of medium and late esophageal cancer has higher efficacy,less side effects and better-tolerance,in contrast with conventional radiotherapy plus chemotherapy.IMRT can increase not only radiation dose for target and local control rate,but also the survival rate without increasing the side effects of radiotherapy.