This randomized phase III trial is to compare simultaneous modulated accelerated boost with standard dose radiotherapy given together with chemotherapy in treating patients with esophageal squamous cell carcinoma.

Inclusion Criteria:

• Histologic proof of primary squamous cell carcinoma of the esophagus.
• Primary disease at cervical, upper or middle thoracic esophagus
• T1-4, N any, M0 (except supraclavicular lymph node).
• Age≥18 & ≤75.
• ECOG score 0-2.
• Platelets ≥ 150,000, Hgb ≥ 10 gm%, ANC ≥ 1500, serum creatinine ≤ 1.5 mg/dl.
• Adequate liver function.
• Patients with prior malignancy are eligible if disease-free ≥ 5 years.
• No prior chest radiotherapy, systemic chemotherapy or major esophageal surgery.
• Signed study-specific informed consent form prior to study entry.

Exclusion Criteria:

• Patients with tracheo-esophageal fistula.
• Patients with invasion into mucosa of trachea or major bronchi.
• Patients with uncontrolled serious medical or mental illnesses.
• Prior RT that would result in overlap of planned RT fields.
• Pregnancy or women of childbearing potential and men who are sexually active
• Women who are breastfeeding a baby.