Objective  This work aims to explore the long-term efficacy and complications of late-course accelerated hyperfractionation (LCAHF) for treating nasopharyngeal carcinoma.

  Methods  A total of 58 patients who consulted from December 2005 to May 2008 and histologically proven nasopharyngeal carcinoma at initial diagnosis were randomized into an LCAHF group (experimental group) and a conventional fractionation (CF) group (control group). The treatment dose for both groups was 2 Gy per fraction once daily, 5 days a week. After the 40 Gy to 50 Gy dose, the dosage in the LCAHF group was increased to two daily doses at 1.5 Gy per fraction 6 h apart, 5 days a week. The total dose in this group was 73 Gy to 76 Gy, the total dose in the CF group was 70 Gy to 76 Gy, with the total course of the treatment shortened by 0.5 weeks to 1.5 weeks in the former group.

  Results  The 5-year control rates of the nasopharyngeal cancers was 86% in the LCAHF group and 59% in the CF group (P=0.021), with statistically significant differences between the two groups. The late complications slightly increased in the LCAHF group than in the CF group, but the differences were not statistically significant.

  Conclusion  LCAHF treatment improves the local control of nasopharyngeal carcinoma without increasing the incidence of long-term complications.