Background: The main objective of this meta-analysis was to determine the effect of concurrent chemoradiotherapy (CCRT) plus adjuvant chemotherapy (AC) compared with radiotherapy (RT) alone for patients with nasopharyngeal carcinoma (NPC).Materials and methods: Two independent investigators comprehensively searched databases and extracted data from randomized, controlled trials (RCTs) in which NPC patients were randomly assigned to receive CCRT+AC or RT alone.Overall survival (OS) with hazard ratios (HRs), locoregional recurrence rate (LRR) and distant metastasis rate (DMR) with relative risks (RRs) were concerned using random and/or fixed-effects models.Results: Six trials (n=1237) were included in this meta-analysis.3-year and 5-year HR of death for the CCRT+AC arm was 0.63 (95% confidence interval (CI) 0.49-0.80, P =0.0002) and 0.70 (95% CI 0.57-0.86, P =0.0008) respectively, corresponding to an absolute survival gain of 12.00% after 3 years and 12.10% after 5 years.Significant reduction ofLRR (P <0.0001;RR =0.52, 95% CI 0.40-0.67) and DMR (P =0.005, RR =0.72, 95% CI =0.57-0.90) was also found for CCRT+AC.Conclusions: The results confirmed that the additional concurrent-adjuvant chemotherapy can improve OS and reduce the locoregional recurrence and distant failure for NPC patients.Further studies are still in need to improve the treatment regimens.