Abstract: 【Objective】 To valuate the efficacy of additional concurrent chemotherapy for patients with intermediate risk (stage II and T3N0M0) nasopharyngeal carcinoma (NPC) in intensity-modulated radiotherapy (IMRT) era. 【Methods】 440 patients with intermediate risk NPC treated with IMRT alone or IMRT plus concurrent chemotherapy between October 2009 and December 2012 in Sun Yat-sen University Cancer Center were studied retrospectively. Propensity score matching was carried out to create radiotherapy group (RT group) and chemoradiotherapy group (CRT group) equally matched for host and tumor factors. 【Results】 We observed no significant difference in estimated three year failure free survival (FFS)

locoregional failure-free survival (LR-FFS)

distant failure-free survival (D-FFS)

and overall survival (OS) between two groups. Multivariate analyses failed to demonstrate concurrent chemotherapy as an independent prognostic factor for FFS

LR-FFS

and D-FFS. However

significantly more severe acute toxicities were observed in the CRT group than in the RT group. There were no significant difference inall survival endpoints between the matched RT cohort and the CRT cohort (FFS: 92.8% versus 91.2%

P = 0.801; LR-FFS: 95.2% versus 94.4%

P = 0.755; D-FFS: 96.4% versus 96.3%

P = 0.803; OS: 98.2% versus 98.9%

P =0.276). 【Results】 Our results demonstrated that for patients with intermediate risk NPC treated with IMRT

additional concurrent chemotherapy did not provide any significant survival benefit but significantly more severe acute toxicities

therefore whether concurrent chemotherapy should be recommended as routine use worth further investigation.