The conventional treatment for patients with locally advanced esophageal cancer has been surgery or radiotherapy. The indication of the treatment depends on the location of the primary tumor, tumor stage, resectability of the lesion and operability of the patient. Radiotherapy is used in a case refusing surgery, medical contraindications to surgery, extensive locoregional disease or poor general condition. The survival rate by surgery alone or radiotherapy alone is poor. Thus, single modality therapy is not a standard treatment, but combined multimodal therapy including chemotherapy is a standard approach for locally advanced esophageal cancer. Further studies of optimization of multimodal therapies which are surgery and/or radiotherapy combined with chemotherapy are needed to improve the results in the treatment of esophageal cancer.