This chapter discusses nasopharyngeal cancer (NPC), which is characterized by a high level of chemo- and radiosensitivity up to relatively late stages since long-term disease-free survivors have been described in metastatic patients. In the patient who presents with only cervical adenopathy, the finding of Epstein-Barr virus (EBV) genomic material in the tissue after amplification of DNA with the polymerase chain reaction lends strong evidence for a nasopharyngeal primary tumor, and a concerted search should be conducted in that area. Post-therapeutic EBV DNA appears predictive of progression-free survival (PFS) since it is thought to reflect accurately post-therapeutic residual tumor load. Four trials have assessed the role of neoadjuvant chemotherapy followed by RT versus RT alone. Three cycles of neoadjuvant cisplatin and 5-FU chemotherapy was followed by conventionally fractionated radiation with additional cisplatin and 5-FU chemotherapy during the boost portion of the radiation course.