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Traditionally, surgery was the treatment of choice, but since surgery alone has a low cure rate and a high complication rate there is increasing use of preoperative chemotherapy combined with radiation (i.e. prior to surgery) or postOp chemoradiation (go here).

Another option is combined chemotherapy and radiation (called chemoradiation) avoiding surgery altogether (go here for a recent review). The current RTOG trial (RTOG 0436) uses chemoradiation alone with 50.4Gy combined with cisplatin/taxol with or without Erbitux, go here.

As well as using targeted therapy like Erbitux, there is benefit from adding Herceptin. (The TOGA trial was the most important study of 2009 in esophagogastric adenocarcinoma. The phase-3 study identified for the first time that there is a benefit to adding a targeted agent to systemic chemotherapy in esophagogastric adenocarcinoma. Combining trastuzumab (Herceptin) with capecitabine/cisplatin or 5-FU/cisplatin improved PFS and OS, and anti-tumor response compared with chemotherapy alone in HER-2–positive patients.) Current chemotherapy options are note here

There are studies that suggest that chemo-radiation alone has the same survival as surgery (go here and here.) Some studies show that chemo-radiation may be superior to surgery (go here). A recent study suggested that in elderly patients chemo-radiation may be as good as surgery in patients with squamous cancer (here).

(see the current NCI section and the current NCCN Guidelines here , here and  here) and NCCN radiation guidelines here, and the physician site here, and advice here.

 Surgical treatment of resectable esophageal cancers results in 5-year survival rates of 5% to 20%, with higher survival rates in patients with early stage cancers. This is associated with a less than 10% operative mortality rate. In an attempt to avoid this perioperative mortality and to relieve dysphagia, definitive radiation therapy in combination with chemotherapy has been studied. One series evaluating radiation therapy and chemotherapy with fluorouracil and mitomycin, produced a 30% actuarial disease-free survival (18% overall survival) at 5 years for stage I and stage II patients.

Radiation alone is clearly not as effective as combined chemo-radiation (go here and here). 

So more patients are now getting chemo-radiation (go here an here.)

Go to the detailed section on treatment here.
An intergroup randomized trial of chemotherapy and radiation therapy versus radiation therapy alone resulted in an improvement in 5-year survival for the combined modality group (26% versus 0%) An Eastern Cooperative Oncology Group trial of 135 patients showed that chemotherapy plus radiation provided a better 2-year survival rate than radiation therapy alone,similar to that shown in the Radiation Therapy Oncology Group trial. A number of phase II studies have suggested improved survival with induction chemoradiotherapy followed by resection when compared with surgery-only historical controls. Approximately 25% of patients achieve a complete pathologic response, albeit in some series at the cost of increased postoperative morbidity and mortality. A multicenter prospective randomized trial in which preoperative combined chemotherapy (cisplatin) and radiation therapy (3,700 cGy in 370 cGy fractions) followed by surgery was compared to surgery alone in patients with squamous cell carcinoma, showed no improvement in overall survival and a significantly higher postoperative mortality (12% versus 4%) in the combined modality arm. In patients with adenocarcinoma of the esophagus, a single institution phase III trial demonstrated a modest survival benefit (16 months versus 11 months) for patients treated with induction chemoradiotherapy consisting of 5-fluorouracil, cisplatin, and 4,000 cGy (267 cGy fractions) plus surgery over resection alone. Therefore, the role of combined modality therapy remains unproven. The results of a national intergroup study showed no statistically significant difference in disease-free or overall survival for preoperative and postoperative chemotherapy alone over surgery alone for adenocarcinoma or squamous cell carcinoma of the esophagus.