Abstract: Objective To evaluate the treatment efficacy and complications of chemotherapy and three-dimensional conformal radiotherapy (3DCRT) for mediastinum lymphonode metastasis after esophageal carcinoma operation. Methods Sixty patients with mediastinal metastasis were randomized into two groups. Thirty patients received chemotherapy and 3DCRT(3DCRT group), and the others as control group received chemotherapy and late course accelerated hyper fractionation (LCAH). All patients were given (38～40)Gy/(19～20)f by 6/15 MV X-ray during the fist two-thirds of the course,and followed by LCAHR and 3DCRT or LCAHR (1.4～1.5) Gy per fraction, twice daily ).The total dose varied up to 65～68Gy.Chemotherapy regimen was FP (5-Fu and DDP). Results Complete response rate was 53.5% and 36.7%,and partial response rate was 43.3% and 36.7% in 3DCRT group and control group after three months treatment. No case with progression of disesse was observed.The CR+PR rate were 90.0% and 80.0%（χ²=1.17,P＞0.05)in 2 groups.The 1,3-and 5-year survival rates were 80.0%、33.3% and 13.3% in 3DCRT group, and 73.3%,20.0% and 6.7%(χ²=0.80、1.36、0.91,P＞0.05) in control group. Conclusion Chemotherapy combined with 3DCRT,with decreased side-effects, markedly improved the local control rate and survival rate of postoperative esophageal carcinoma patients with mediastinum lymphonode metastasis.