Objective:To study the survival and prognostic factors of esophageal cancer treated with three - dimen-sional radiotherapy and chemotherapy. Methods:We collected the clinical data of 167 patients with advanced stage e-sophageal cancer received the chemo - radiation as the initial treatment modality. The radiotherapy equipment for Ele-kta - 6mV Xray linear accelerator,radiotherapy using three - dimensional conformal radiotherapy(3 - DCRT)or in-tensity - modulated radiotherapy(IMRT)and radiotherapy in a dose 62Gy. Chemotherapy was fluorouracil + cisplatin or docetaxel + cisplatin,respectively,4 ~ 6 cycles. The Kaplan - Meier method was used to calculate the overall surviv-al(OS),and to draw the survival curve,Log - rank method was used for univariate analyze,and Cox regression was used for multivariate analsis. Results:Among all patients,the 1 year,3 years,5 years survival rates were:73. 7% , 51. 5% ,26. 3% . The median survival time was 36 months. Univariate analysis results showed treatment modality, tumor location,tumor length,tumor stage,radiotherapy,radiation pneumonia were influencing the survival of patients with esophageal cancer(P = 0. 022,0. 017,0. 040,0. 001,0. 000,0. 002). Multivariate analysis by Cox model showed that treatment modality,tumor length,tumor stage,radiation pneumonia were independent factors affecting on the sur-vival of esophageal cancer(P = 0. 018,0. 001,0. 004,0. 000). Conclusion:Concurrent radiotherapy and chemothera-py significantly improve the overall survival rate of patients with advanced esophageal cancer. The tumor size < 5cm, early stage,lower level of radiation pneumonia are associated with better prognosis.%目的：探讨食管癌三维放疗+化疗生存情况及预后影响因素。方法：收集在我院首次行放化疗的167例中晚期食管癌患者的临床资料，并进行回顾性分析。放疗设备为 Elekta -6mV X 线直线加速器，放疗方案采用三维适形放疗（3- DCRT）或调强放疗（IMRT），放疗中位剂量为62Gy。化疗方案为氟尿嘧啶+顺铂或多西紫杉醇+顺铂，分别行4～6周期。采用 SPSS 17.0软件行 Kaplan - Meier 法计算总生存率（OS），并绘制生存曲线，Log - rank 法检验 P 值，对 P <0.05的单因素行 Cox 回归多因素分析。结果：全组患者1年、3年、5年生存率分别为73.7%、51.5%、26.3%，中位生存时间36个月。单因素结果显示治疗方式、肿瘤位置、肿瘤长度、肿瘤分期、放疗剂量、放射性肺炎为影响食管癌患者生存的主要因素（P =0.022、0.017、0.040、0.001、0.000、0.002）。Cox 多因素分析发现治疗方式、肿瘤长度、肿瘤分期、放射性肺炎为影响食管癌预后生存的独立影响因素（P =0.018、0.001、0.004、0.000）。结论：同步放化疗可明显提高中晚期食管癌患者总生存率，当肿瘤长度<5cm、肿瘤分期越早、放射性肺炎级别越低时患者预后较佳。
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