A total of 36 patients with nasopharyngeal cancer underwent radiotherapy followed by CDDP-based adjuvant chemotherapy during the period from 1983 to 1991. The survival rate in the cases treated with radiotherapy followed by adjuvant chemotherapy was better than in 53 cases treated with radiotherapy alone. Distant metastasis was noted in only 8 (22%) of the former cases as opposed to 21 (40%) of the latter. In particular, multiple metastasis to both sides of the neck was found in 12 (63%) of 19 cases treated with radiotherapy alone, but in only 1 of the 10 cases treated with adjuvant chemotherapy. The interval until the detection of metastasis was also longer in the latter group. The above results suggest that adjuvant chemotherapy suppresses distant metastasis and contributes to the improvement of the clinical outcome in nasopharyngeal cancer.