Inclusion Criteria:

- Histologically proven nasopharyngeal carcinoma

- Non-keratinizing or undifferentiated type Stage III-IVB (by AJCC/UICC 6th edition)

- Essential staging investigations: CT or MRI of nasopharyngeal region Chest x-ray (or
CT thorax)

- Liver function test, alkaline phosphatase Liver and bone scan if alkaline phosphatase
exceeds the institutional upper limit of normal, or if clinically indicated.

- Liver scan if SGOT exceeds the institutional upper limit of normal

- Adequate marrow: WBC > 4 and platelet > 100

- Adequate renal function: creatinine clearance > 60 ml/min.

- Satisfactory performance status: > 2 by ECOG System.

Exclusion Criteria:

- WHO Type I squamous cell carcinoma or adenocarcinoma

- Age > 70

- Treatment with palliative intent (including those with tumor extent mandating the use
of AP opposing facio-cervical field technique)

- Prior malignancy except adequately treated basal cell or squamous cell skin cancer,
in-situ cervical cancer, or other cancer for which the patient has been disease-free
for five years.

- Pregnancy or lactation (consider pregnancy test in women of child-bearing age and
emphasize effective contraception during the treatment period).

- History of previous RT (except for non-melanomatous skin cancers outside intended RT
treatment volume).

- Prior chemotherapy or surgery (except diagnostic) to primary tumor or nodes.