A Multicenter Trial Comparing Induction C/T Followed by CCRT v.s. CCRT Alone in Stage IV Nasopharyngeal Carcinoma

Inclusion Criteria:

* Histologically proved nasopharyngeal carcinoma.
* T4NxM0 or TxN3M0 disease by UICC/AJCC 1997 staging system. (30)
* Eastern Cooperative Oncology Group performance status \< 2.
* A leukocyte count ≥3750/mL, Hb ≥ 10 g/dL, and a platelet count ≥100,000/mL.
* A serum bilirubin level \< 1.5 mg/dL, serum creatinine level \< 1.6 mg/dL or creatinine clearance \> 60 mL/min.
* Age less than 70 years old
* An informed consent signed.

Exclusion Criteria:

* Evidence of metastatic disease.
* Presence of another malignancy other than treated squamous/basal cell carcinoma of the skin.
* Presence of uncontrolled hypertension, poorly controlled heart failure.
* Presence of active infection.
* Patients who have been or are being treated with chemotherapy, radiotherapy, immunotherapy, or other experimental therapies.
* Women who test positive for pregnancy.