Abstract: To evaluate the efficacy and toxicity of the weekly dose of Nedaplatin combined with radiation for esophageal squamous cell carcinoma in elderly patients. Methods: Forty-nine patients were randomly divided into two groups to receive either radiotherapy only ( Group 1, 25 cases ) or weekly dose of Nedaplatin combined with radiotherapy ( Group 2, 24 cases ). Patients in both groups received conventional radiotherapy with a total dose of 60 Gy to 66 Gy. In Group 2 30 mg/m2 of Nedaplatin was administered once a week for six successive weeks starting from the first day of radiotherapy. Results: Among the 24 patients in Group 2, 10 patients achieved CR ( 41.7% ), 11 PR ( 45.8% ), and the reponse rate ( CR plus PR ) was 87.5%. On the other hand, in Group 1, 4 patients achieved CR (16.0%), 11 PR ( 44.0% ), and the response rate ( CR plus PR ) was 60.0% ( P < 0.05 ). The occurrence rate of G2/3 toxicity of leukopenia in Group 2 was 54.2%, which was obviously higher than that in Group 1 ( P < 0.05 ). The occurrence rates of G2/3 toxicity of radiation esophagitis between the two groups did not have statistical differences. Conclusion: Weekly dose of Nedaplatin combined with radiotherapy can effectively treat esophageal cancer in elderly patients.