This multicenter open labeled phase 2 trial examines the efficacy of a combination of Gemcitabine 1000 mg/m2 (30 min), Cisplatin 30 mg/m2 (90 min), Folinic Acid 200 mg/m2 (30 min) and 5-FU 750 mg/m2 (24h CI) all given day 1,8 q D22 in patients with inoperable esophageal cancer. The combination was considered to be suitable for further evaluation with a freedom of progression rate (PR+CR+SD) of more than 60% and not be be of further interest with a rate of less than 40%. Given an alpha error of 5% and an beta error of 10% at least 66 evaluable patients were needed based on a 2-Stage Simon design with a first evaluation after 25 evaluable patients.

Inclusion Criteria:

• Age>=18
• Histologically proven inoperable esophageal cancer
• Karnofsky Performance status >=60%
• Estimated life expectancy of > 12 weeks
• Measurable disease
• No other oncologic therapy
• Measurable disease
• Adequate bone marrow function
• Geographic proximity and compliance
• Informed consent
• Negative pregnancy test and adequate contraception

Exclusion Criteria:

• Insufficient hepatic or renal function
• Elevated serum calcium
• Pregnancy/breast feeding
• Active infection
• Other malignancies
• Systemic tumour complications requiring emergency interventions