Background. The objective of this study was to evaluate the prognostic value of the cumulative cisplatin dose (CCD) for long‐term survival outcomes after concurrent chemoradiotherapy (CCRT) in locoregionally advanced nasopharyngeal carcinoma (NPC). Methods. Patients were included in an open‐label phase III multicenter randomized controlled trial performed at seven institutions in China, and the 298 patients receiving CCRT only were assessed. Patient survival between different CCD groups were compared. Results. Median CCD for the 298 patients was 240 mg/m2 (range, 40–320 mg/m2); 113 (37.9%) patients received a CCD of <240 (≤200) mg/m2, and 185 (62.1%) received a CCD of ≥240 mg/m2. For CCD of ≥240 mg/m2 vs. <240 mg/m2, the estimated 5‐year overall survival, disease‐free survival, locoregional relapse‐free survival, and distant metastasis‐free survival rates were 83.2% vs. 76.2% (p = .403), 73.5% vs. 67.8% (p = .461), 90.4% vs. 86.8% (p = .551), and 82.6% vs. 79.7% (p = .632), respectively. Multivariate analysis demonstrated that CCD (240 mg/m2) was not an independent prognostic factor in either the entire cohort or stage III/IV subgroup. Conclusion. A CCD of ≥240 mg/m2 was not an independent prognostic factor in patients with locoregionally advanced NPC at high risk of distant metastasis, and 200 mg/m2 cisplatin may be adequate to achieve a survival benefit. Implications for Practice: The current standard treatment for locoregionally advanced nasopharyngeal carcinoma (NPC) is cisplatin‐based concurrent chemoradiotherapy (CCRT), and the cisplatin is delivered every 3 weeks (100 mg/m2) for three cycles. However, the prognostic value of cumulative cisplatin dose (CCD) delivered during CCRT is controversial. The present study investigated the prognostic value of CCD and demonstrated that a CCD of 200 mg/m2 during CCRT is adequate to achieve satisfactory survival outcomes for patients with locoregionally advanced NPC. This finding is of great importance to clinicians because it could allow patients to avoid excessive treatment and toxicities. 摘要 背景. 本研究旨在评价顺铂累积剂量(CCD)对局部晚期鼻咽癌(NPC)患者同步放化疗(CCRT)后长期生存转归的预后价值。 方法. 在中国的7家机构开展了一项开放标签的III期多中心、随机对照临床试验, 本研究仅评估其中298例仅接受CCRT治疗的患者。比较不同CCD组的患者的生存。 结果. 298例患者的中位CCD为240 mg/m2(范围40∼320 mg/m2), 113例(37.9%)患者接受的CCD < 240(≤200)mg/m2, 而185例(62.1%)接受的CCD≥240 mg/m2。CCD≥240 mg/m2和<240 mg/m2患者的估算5年总生存率、无疾病生存率、局部无复发生存率和无远处转移生存率分别为83.2% vs. 76.2%(P=0.403)、73.5% vs. 67.8%(P=0.461)、90.4% vs. 86.8%(P=0.551)和82.6% vs. 79.7%(P=0.632)。多变量分析证实CCD(240 mg/m2)不是总队列或III/IV期亚组的独立预后因素。 结论. CCD≥240 mg/m2不是具有远处转移高风险的局部晚期NPC患者的独立预后因素, 顺铂200 mg/m2可能足以达到生存获益。The Oncologist 2016;21:1369–1376 对临床实践的提示: 目前局部晚期鼻咽癌(NPC)的标准治疗是含顺铂的同步放化疗(CCRT), 顺铂每3周给药一次(100 mg/m2), 共3周期。但CCRT治疗过程中顺铂累积剂量(CCD)的预后价值仍有争议。本研究调查了CCD的预后价值, 并证实局部晚期NPC患者的CCRT中给予CCD 200 mg/m2足以达到满意的生存转归。本研究结果对临床医生意义重大, 因为这些结果使得患者得以避免过度治疗及毒性。 This study evaluated the prognostic value of the cumulative cisplatin dose (CCD) for long‐term survival outcomes after concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC). A CCD of ≥240 mg/m2 was not an independent prognostic factor in patients with locoregionally advanced NPC at high risk of distant metastasis, and 200 mg/m2 cisplatin may be adequate to achieve a survival benefit.