There has been no controlled trial of radiotherapy versus surgery for squamous cell carcinoma of the oesophagus. Radiotherapy is generally used for those patients with extensive disease or those who are unfit for surgery. In spite of this, the 1-year survival of 18 per cent is similar to that for surgically treated patients and there is no equivalent operative mortality. The 5-year survival is 6 per cent compared with that for surgery of 4 per cent. There are no results available to suggest what would happen if a patient with a localized tumour, technically suitable for surgical resection, were treated instead by radiotherapy.