How to treat esophageal cancer found in patients over 70 years old is indeed a headache for family members. I myself will briefly talk about my experience: Firstly, I personally think that only the effect of concurrent radiotherapy and chemotherapy can be compared with the effect of surgery, and the chance of curing esophageal cancer by radiotherapy and chemotherapy alone is extremely low. Secondly, the toxic side effects or pain of concurrent radiotherapy and chemotherapy may be greater than surgery, but once successfully completed, the quality of life is very good. Because so gastroesophageal reflux (common symptoms are heartburn, hiccups, chronic cough, etc.) and poor eating (common chest tightness, panic, choking after eating, etc.) after esophageal surgery and other decreases in quality of life due to digestive tract reconstruction may be problems that cannot be solved for a long time, or even for a lifetime. 1. Patients who were in very good health in the past are undoubtedly preferred to surgery if they belong to the middle and early stage, and if If they belong to middle and late stage, surgery after neoadjuvant chemotherapy or direct radical radiotherapy is recommended; 2. Patients with average previous health condition and middle and early stage cancer, surgery is recommended, and whether to adjuvant chemotherapy is decided according to postoperative pathological results and postoperative recovery; the choice of middle and late stage cancer is the most tangled, once radical radiotherapy is chosen, and once the scheduled course of radiotherapy and chemotherapy cannot be completed, it is very passive; and neoadjuvant chemotherapy after surgery is recommended. I personally think that if you are financially strong, you should recommend surgery after neoadjuvant chemotherapy and strengthen nutritional support therapy or even immune support during chemotherapy, but the cost of treatment will increase significantly by about 20%; if you are financially weak, you should cautiously recommend surgery or simply radiotherapy to solve the problem of eating. If the economic base is poor, it is prudent to recommend surgery, or simply radiotherapy to solve the problem of eating, the physical condition will be significantly better after the problem of eating is solved, and also to win the physical condition for remedial surgery after radiotherapy relapse in the future. After all, economic pressure is what the majority of patients need to face when they see a doctor in China.3. Patients with poor physical condition and chronic comorbidities in the past, only early-stage cancer is recommended to prefer surgery, while surgery is cautiously recommended for early and middle-stage cancer, and patients with mid- to late-stage cancer may only have the chance to solve the eating problem by radiotherapy alone. For young patients, especially those in the age group of 40-60, surgery is indispensable in the treatment plan. Early stage is definitely surgery first. As to whether surgery after neoadjuvant chemotherapy or surgery after neoadjuvant chemotherapy plus half amount of radiotherapy for patients with intermediate and advanced cancer is inconclusive for squamous cell carcinoma of esophagus, which is common in China. I personally tend to operate after neoadjuvant chemotherapy.