Abstract: Objective : To compare the curative effect and toxicity of escalated whole course accelerated hyperfrac-tionation (EWCAHF) and late course accelerated hyperfractionated (LCAHF) regimen for esophageal carcino-ma. Methods : From July 2001 to October 2002, 60 cases of esophageal squamous cell carcinoma were ran-domly divided into two groups: 30 in the EWCAHF group and 30 in the LCAHF group. The LCAHF group re-ceived a conventional radiation dose in the first 4-week period of 40 Gy/20 fx, followed by hyperfractionationRT, twice daily with a minimum interval of 6 hours. The dose was 30 Gy/20 fx, with a total dose of 70Gy/40fx/40~45 days. In the EWCAHF group, patients received radiotherapy twice a day with a 6-hour minimum inter-val. In the first and second week, patients received 1.2 Gy per RT, then 1.4 Gy per RT in the followingtwo-week period, and finally 1.6 Gy per RT in the 5th week, with a total dose of 68Gy/50fx/34~38days. Results : The follow-up rate was 100%. The 1-, 3-, and 5-year locoregional control rates were 74.6%, 64.9%, and59.4% in the EWCAHF group and 68.8%, 54.7%, and 33.8% in the LCAHF group (P=0.099). The 1-, 3-, and5-year survival rates were 93.3%, 45%, and 33.3% in the EWCAHF group and 80%, 41.6%, and 23.3% in theLCAHF group (P=0.077). No statistical significance was found in acute side effects or late complications be-tween the two groups (P>0.05). Conclusion : EWCAHF can improve the locoregional control rate and the sur-vival rate of patients with esophageal cancer, without increasing acute side effects and late complications.