Abstract: Objective:To study whether intensive neoadjuvant chemotherapy and a break in radiation treatment have a significant impact on survival in patients with nasopharyngeal carcinoma (NPC) treated with radiotherapy.Methods:This study was a retrospective review of1,706 patients with NPC treated with radiotherapy with or without chemotherapy at a single institution and between January 1995 and December 1998. There were 1,081 patients treated with radiotherapy alone and there were 625 who also received an intensive course of neoadjuvant chemotherapy. Chemotherapy, if given, was cisplatin-based, given every 14days for 2-3 cycles. The chemotherapy regimen consisted of cisplatin80mg/m2 by rap -id Ⅳinfusion given on 3 consecutive days (days 1 to 3) and 5-FU 750 mg/m2 /day by  infusion on days 1 through 5. Radio-therapy normally started within 2-5 days of completion of the last cycle of chemotherapy. A total of 177 out of 1,706 patients had a radiation-free period lasting more than one week. Patient, tumor and treatment factors were analyzed for their signifi-cance on long term overall survival (OS). Researchers analyzed whether intensive neoadjuvant chemotherapy and a radia-tion-free period had a significant impact on survival in patients with nasopharyngeal carcinoma (NPC). Results: The median follow-up was 75months (range 6 to 120 months). The follow-up rate was90.50% with162 of the patients not completing follow-up. The 3- and 5-year OS rates were 79.2% and 67.6%, respectively. Multivariate analysis showed that gender, ane-mia, tumor stage (T stage, N stage, M stage and TNM stage), chemotherapy and radiation-free periods were independent significant factors (P<0.05) associated with long-term survival. The 5-year OS rates were 100 %,75.9%,66.5% and 49.3% for stages Ⅰ, Ⅱ, Ⅲand Ⅳ(P<0.05); the 5-year OS rates were 65.3% (95% CI79.64%-86.94% ) and60.5% (95% CI 75.47%-82.4%) for stageⅢ/Ⅳpatients treated with or without neoadjuvant chemotherapy ( P=0.041 ); the 5-year OS rates were51.7% (95% CI44.95％-58.43%) and69.5% (95% CI67.24%-71.66%) for patients with or without a treatment break (P<0.001 ), respectively. Conclusion:Intensive neoadjuvant chemotherapy and continuous radiation treatment seem to be favorable factors associated with long term survival in patients with NPC.