目的：评价大剂量Ｃｉｓｐｌａｔｉｎ，５－Ｆｕ及ＢＬＭ新辅助化疗在中晚期鼻咽癌治疗中的价值。材料及方法：１９９２～１９９３年，４４０例治疗前行ＣＴ或ＭＲ检查确诊为Ⅲ、Ⅳａ期鼻咽癌（＇９２分期），随机分为化疗＋放疗组（２１９例），及单纯放疗组（２２１例）。化疗方案：Ｃｉｓｐｌａｔｉｎ：２０ｍｇ／ｍ２１～５天，５－Ｆｕ５００ｍｇ／ｍ２１～５天，ＢＬＭ：７ｍｇ／ｍ２１、５天，化疗两个疗程。放射治疗鼻咽剂量：６６～７４Ｇｙ／（３３～３７次）·（７～９周）。颈部淋巴结剂量：６０～７０Ｇｙ／（３０～３５次）·（７～８５周），颈部预防量：４８～５０Ｇｙ。生存分析采用总生存率，无瘤生存率，无局部区域复发生存率、无远处转移生存率，无局部复发生存率。结果：５年生存率及无远处转移生存率：实验组及对照组分别为５７１７％ＶＳ５１０７％（Ｐ＞０．０５）及７５５３％ＶＳ７３２４％（Ｐ＞０．０５）；无瘤生存率及无局部区域复发生存率分别为５５１３％ＶＳ４５３４％（Ｐ＞０．０５）及７２４３％ＶＳ６２２０％（Ｐ＞０．０５）。Ｔ３、Ｔ４无局部复发率分别为８１４０％ＶＳ６７４３％（Ｐ＜Ｏ．０５）及７００５％ＶＳ５８４０％（Ｐ? Objective: To evaluate the value of high-dose neoadjuvant chemotherapy with Cisplatin, 5-Fu and BLM in the treatment of advanced nasopharyngeal carcinoma. Materials and Methods: From 1992 to 1993, 440 patients were diagnosed as stage Ⅲ and Ⅳa nasopharyngeal carcinoma (’92 stage) by CT or MR before treatment. They were randomly divided into chemotherapy + radiotherapy group (219 cases) and radiotherapy alone group 221 cases). Chemotherapy program: Cisplatin: 20mg / m21 ~ 5 days, 5-Fu500mg / m21 ~ 5 days, BLM: 7mg / m21, 5 days, two courses of chemotherapy. Radiation therapy nasopharyngeal dose: 66 ~ 74Gy / (33 ~ 37 times) · (7 ~ 9 weeks). Cervical lymph node dose: 60 ~ 70Gy / (30 ~ 35 times) · (7 ~ 85 weeks), the amount of neck prevention: 48 ~ 50Gy. Survival analysis using the overall survival rate, tumor-free survival rate, no regional recurrence survival rate, no distant metastasis survival rate, no local recurrence survival rate. Results: The 5-year survival rate and distant metastasis-free survival rate were 5717% VS 5107% (P> 0.05) and 7553% VS7324% (P> 0) in experimental group and control group respectively. 05). The tumor-free survival rates and those without local recurrence were 55.13% vs 45.34% (P> 0.05) and 72.43% VS62.20% (P> 0.05), respectively. No recurrence rates of T3 and T4 were 8140% VS 6743% (P <0.05) and 7005% VS5840%