Background: As age-related infirmity often influences treatment options and outcome of esophageal cancer, the optimization of treatment for the elderly, especially in octogenarians, has been the subject of considerable debate. Methods: We performed a retrospective, multi-institutional survey to assess the effectof age on the outcome of definitive radiotherapy for esophageal cancer by a questionnaire sent to eight institutions in Japan. Results: Therewere362evaluable replies. Thepatients included 317 males and 45 females, with a median age of 72 years (range 35-93 years), and 96% had squamous cell carcinoma. There were30 clinical stage I, 71 stage IIA,17 stage IIB, 113 stage III and 116 stage IV cases. The stage was not specified in 16 cases. Multiple co-morbidities existed in 40°!c> of the patients who were 70 years of age or older. Therewas no statistically significant age-related difference in the incidence of adverse reactions to radiotherapy (P > 0.05). Overall survival was more significantly affected by Karnofsky Performance Statusthan by the patient's age. The influence of performance status on cumulative survival for stage I and II disease was more pronounced in patients in their 80s. Conclusion: The safety of radiotherapy for esophageal carcinoma is not influenced by the patient's age. Because the performance status strongly influenced survival, the multi-disciplinary assessment of functional status is mandatory for optimizing the choice of treatmentfor patients in their 80s with esophageal cancer.