Abstract: Objective : To study the impact on the locoregional control and metastasis and acute toxicity in patients with nasopharyngeal carcinoma (NPC) who were treated with 2 cycles of induction chemotherapy (ICT) followed radical radiotherapy alone (RT) and radiotherapy concomitant to HCFU chemotherapy (RTCHC). Methods Sixty-six newly diagnosed patients with Stage Ⅲ and Ⅳ (Fu Zhou, 1992) NPC were recruited onto two randomized trials, namely, half of them for RT, and half for RTCHC. Both were treated with 2 cycles ICT followed RT and RTCHC. Results : After two circles of induction chemotherapy, the overall response rate of nasopharyngeal tumor and cervical nodal disease were 84.8% and 89.1%, respectively; the complete response rate of nasopharyngeal tumor and cervical nodal disease were 4.5% and 12.7%, respectively, and the partial response of that was 80.3% and 76.4%, respectively. The average complete response dose of nasopharyngeal tumor for RT and RTCHC was 62.0303±7.9039Gy and 54.1515±8.1399Gy (P0.01) respectively (P=0.036), and that of the cervical nodal disease was 60±8.9443 Gy and 49.037±9.4359 Gy respectively(P0.001). After three months of radiotherapy, the complete response rate of 90.9% of nasopharyngeal tumor for RTCHC was more than that of 66.7% for RT (P=0.016), and that of 92.6% of cervical nodal disease for RTCHC was more than that of 71.4% for RT (P=0.042). After a median follow-up of 13 months, the locoregional recurrent rates of 3% of the nasopharyngx for RTCHC as less than that of 15.2% for RT (P=0.087), and that of 3.7% of the neck for RTCHC was less than that of 14.3% for RT (P=0.163). The systemic metastasis rate of 15.2% for RT was more than that of 6.1% for RTCHC (P=0.230). Adverse effects, such as leukopenia, mucositis, nausea, dermatitis and so on, were observed in the treated patients. Conclusion : Induction chemotherapy followed radiotherapy concomitant HCFU is effective in the patients with local advanced NPC, thus reducing the dose of the complete repose. The locoregional control and systemic metastasis seem encouraging. Although the acute toxicity in the patients receiving RTCHC is aggravated, but it was endurable. This single institution experience deserves further investigation in prospective trials.