目的　评价支架置入或放疗以及二者联合应用在中晚期食管癌治疗中的作用。方法　将 2 30例患者分为三组 :先放疗后支架置入组 ,单纯支架置入组和支架置入后放疗组。随访观察比较各组疗效、不良反应、并发症及生存率。结果　放疗改善梗阻症状较慢但副反应轻 ,出现并发症再置入支架的难度大于单纯支架置入组 ,疼痛增加且较重 ,但生存期长于另外两组。单纯支架置入组患者在 1～ 3d内症状缓解 ,生存期短于另外两组。支架置入后再放疗的患者并发症较多且重 ,放疗计划完成困难 ,生存期介于另外两组之间。结论　中晚期食管癌宜先行放疗 ,酌情行支架置入既可延长生存期又可缓解症状。支架置入后再行放疗虽然可以延长患者生存期 ,但放疗反应重。单纯支架置入仅能缓解症状 ,6个月后复发率增加 Objective To evaluate the role of stent implantation or radiotherapy and their combination in the treatment of advanced esophageal cancer. Methods 230 patients were divided into three groups: first radiotherapy stent implantation group, stent implantation group and stent implantation radiotherapy group. Follow-up observation compared the curative effect, adverse reaction, complication and survival rate of each group. Results Radiotherapy improved the symptoms of obstruction more slowly but with less side effects. Complications were more difficult to be placed in stents than simple stents. The pain was increased and heavier, but the survival time was longer than the other two groups. The patients in the stent group were relieved of symptoms within 1 ~ 3d and had shorter survival than the other two groups. Stent placement and then radiotherapy in patients with more and more serious complications, radiotherapy plan to complete the difficulty of survival between the other two groups. Conclusions The treatment of advanced esophageal cancer should be preceded by radiotherapy, as appropriate stent placement can both prolong survival and alleviate the symptoms. Radiotherapy after stent placement can prolong the survival of patients, but the response to radiation is heavy. Stenting alone can only alleviate the symptoms, 6 months after the recurrence rate increased