OBJECTIVE： To observe clinical efficacy and safety of tegafur gimeracil oteracil potassium combined with 3D-CRT and microwave hyperthermia in the treatment of  elderly patients with local advance esophageal cancer. METHODS： 48 cases of local advance esophageal cancer were divided into group A， B and C according to random number table method， with 16 cases in each group according to random number table method. Group A was given 3D-CRT with total dose of 60-66 Gy totnlly for 6-7 weeks； group B was additionally given tegafur gimeracil oteracil potassium 60 mg/（m2·d）， bid， on the basis of group A 3 weeks for a course of treatment， until the end of radvotherapy； group C was additionally given thermotherapy on the basis of group B 3 weeks for a course of treatment， until the end of radvotherapy.  Clinical efficacy， 1-year survival rate， dysphagia， weight and KPS score were compared among 3 groups， and the occurrence of toxic reactions （radioactive esophagitis， radioactive pneumonia， bone marrow suppression and gastrointestinal reaction） were observed in 3 groups. RESULTS： Total effective rate， 1-year survival rate and the remission rate of dysphagia of group C were 93.75％， 87.50％ and 93.75％， which were significantly higher than those of group A （50.00％， 50.00％ and 56.25％） and B （68.75％， 68.75％ and 68.75％）， with statistical significance （P＜0.05）. There was no statistical significance in the rate of weight gain and KPS score gain among 3 groups （P＞0.05）. The incidence of radioactive esophagitis and radioactive pneumonia in group C were significantly lower than in group A and B， with statistical significance （P＜0.05）； there was no statistical significance in the incidence of gastrointestinal reaction and bone marrow suppression among 3 groups （P＞0.05）. CONCLUSIONS： Tegafur gimeracil oteracil potassium combined with 3D-CRT and microwave hyperthermia in the treatment of elderly patients with local advance esophageal cancer further improves clinical efficacy and survival rate， but shows low incidence of toxic reaction.