To evaluate the effect and complications of esophageal carcinoma treated by external beam and intracavitary radiation with carboplatin chemotherapy. From September 1993 to May 1994, 129 advanced esophageal carcinoma patients were treated by combined radiotherapy and chemotherapy with prospective randomized study. All confirmed by pathological as squamous cell carcinoma. The follow-up rate was 98.5%. Group A: 33 patients received conventional radiotherapy. Group B: 32 patients were given external beam and intracavitary irradiation. Group C:31 patients received the external and intracavitary irradiation as same as Group B, and plus single drug carboplatin as chemotherapy. Group D: 33 patients were given external beam radiotherapy as same as group A and the chemotherapy regimen identified to group C. The 3-,4-year survival rates were significant difference between groups A and D, p=0.027 and p=0.071 respectively; The 3-year disease-free survival rates of group D 36.9% (12/33) was higher than those of group A 15.2% (5/33), p=0.048; The A, B, C and D group's median survival time were 12 months, 18 months, 13 months and 16 months, respectively. Non-carcinomatous esophageal stenosis, ulcer and fistula were the common and severe complications. There were no significant difference in any groups about the ulcer and fistula mortality, but esophageal stenosis in groups B, C were 43.8%(14/32) and 38.5%(12/31) higher than groups A, D 9.1%(3/33) and 12.1%(4/33), P<0.05. 108 patients had died. The local failure resulted in dead 63 cases (58.3%). In group A, die of local relapse 55.2%(16/29) were markedly higher than group B 22.2%(6/27), p=0.012 and group C21.4%(6/28), p=0.009. The external beam with intracavitary radiation show the local relapse down but could not improved the long-term survival, and the severe complications were markedly higher influencing the quality of life and the survival; External beam radiation plus carboplatin chemotherapy seemed to improve the survival rates and need intensive study.