Abstract: 【Objective】 To identify the independent prognostic factors and optimize the treatment for nasopharyngeal carcinoma (NPC) patients initial with distant metastasis.【Methods】 A total of 230 patients who met the inclusion criteria were retrospectively analyzed. The median age was 48 years. The most common sites of metastasis was bone (67.0%)

then were liver (32.6%) and lung (15.7%). All the patient received at least one cycle of cisplatin-based chemotherapy and the median cycle of chemotherapy was 5. Clinical features

laboratory parameters and treatment modality were compared by univariate and multivariate analyses. 【Results】 The median follow-up time and overall survival time were 21 months and 24 months and the 3-year

5-year overall survival rates were 27.8%

16.7%. The overall response and disease control rates of metastatic lesions after chemotherapy were 55.6% and 89.1%.The rates of completed/partial response(CR/PR)

stable disease(SD) and progression disease (PD) were 55.6%

33.5%

and 10.9%. The factors associated with poor survival were KPS 3

anemia

LDH > 245 U/L and number of chemotherapy cycles 245 U/L

number of chemotherapy cycles <4

mutiple-organ metastasis and more than 3 metastatic lesions. 【Conclusion】 The prognostic factors of KPS

N classification

liver metastasis

number of lesion

HB level

LDH level and the response to chemotherapy help to predict the survival for NPC patients initial with distant metastasis. A combination of radiotherapy and chemotherapy has survival benefits for selected patients having fewer negative prognosticators