From November 1990 to July 1991, data on 21 patients with primary squamous cell carcinoma of the thoracic esophagus were used for the present study. Among these 21 cases, 10 received only chemotherapy (Group A) and 11 were given hyperthermo-chemotherapy (Group B). Six and nine cases were surgically treated after preoperative chemotherapy or hyperthermo-chemotherapy in Group A and B, respectively. After treatment of Group A or B, 5/10 patients in Group A (50%) mentioned improvement in swallowing capability, as did 9/11 patients (81.8%) in Group B. In the upper GI series, done after treatment, a complete response was seen in one case in Group B, while a partial response was obtained in 3 patients (30%) and in 3 patients (27.3%) with minimal response in Group A and B, respectively. A histopathologic examination of the resected specimen revealed marked effectiveness in 0 and one (11.1%) patients, and moderate effectiveness in 1 (16.7%) and 2 (22.2%) patients in Group A and B, respectively. Consequently, this intensive treatment should be expected to greatly improve local control without causing either any severe side effects or complications.