centers in China. They were randomly assigned to CCRT followed by adjuvant CT (CCRT+CT) arm or RT alone arm. All patients were treated with IMRT. The chemotherapy consisted of concurrent cisplatin (80 mg/ m2 on day 1, 22, 43) during IMRT and 3 cycles of adjuvant CT with cisplatin 75mg/m2 day 1, 5-FU 750 mg/m2 24h-continuous infusion day 1-5 every 3 weeks. The primary endpoint was overall survival (OS). Secondary endpoints included locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), and toxicities. Survivals were calculated with Kaplan-Meier method. The differences between survivals were calculated by Log-rank test. Toxic effects were analyzed using the c 2 test. All statistical tests were two-side. Results: A total of 168 patients were recruited and 160 were eligible for intent-for-treat analysis. 81 patients were assigned to CCRT+CT arm and 79 in RT alone arm. With a median follow-up of 61.5 months, the 3-year and 5-year OS of all patients were 93.75% and 90.00%, respectively. The 3-year and 5-year OS of CCRT+CT arm were 93.83%, 91.36%, respectively, and 93.67% and 88.61% in RT arm, respectively. There was no significant difference in OS between two arms (P Z 0.562). The 3-year and 5-year LRFFS of CCRT+CT arm were 97.53%, 96.26%, respectively, and 94.94% and 93.67% in RT arm, respectively. There was no significant difference in LRFFS between two arms (P Z 0.690). The 3-year and 5year DMFS of CCRT+CT arm were 93.82%, 93.82%, respectively, and 96.20% and 93.67% in RT arm, respectively. There was also no significant difference in DMFS between two arms (P Z 0.967). There were higher local radiation acute and late side effects in the CCRT+CT arm than RT arm although not reached significant. There were significantly higher acute systemic side effects in the CCRT+CT arm, especially the incidence of grade 3-4 hematologic and gastrointestinal reactions (P Z0.000). Most of locoregional recurrence (6/8, 75.00%) and distant metastases (6/7, 85.71%) occurred in the T2N1M0 group. Conclusion: For stage II NPC patients treated with IMRT, CCRT and adjuvant CT did not improve OS, LRFFS and DMFS. But there were more significant toxicities. Chemotherapy may not be necessary in these patients. However, further research with longer follow up is needed especially for those with T2N1 disease.