Background: Although the acute toxicities during induction TPF are well known, little is studied about the long term outcomes including complications. The purpose of this study is to evaluate the survival and long term complications in NPC patients treated with induction TPF followed by CCRT. Methods: From May 2004 to December 2016, 244 patients diagnosed as NPC and 101 patients who completed the 3 cycles of TPF followed by CCRT were evaluated. During radiotherapy, cisplatin was given at a dose of 40 mg/m²/wk or 100 mg/m² per 3 weeks (Clcr adjusted) and radiotherapy (65–70 Gy) was starting 4–6 wks after the third cycle of IC. After completing IC and CCRT, follow up imaging and regular physical examination for ENT by specialist were checked. Results: The median follow-up duration was 60 months (range, 7-135). Fiver year-OS rate and 3Y-PFS rate were 88.9±3.7% (95%CI 81.65-96.15) and 80.4±4.5 (95%CI 71.58-89.22). PFS was significantly associated with TNM (p= 0.001), especially N stage (N3, 3Y-PFS 42.9%, p= 0.001). ENT complications such as hearing impairment, chronic infection, ear drum perforation were shown in 27 patients (26.7%) and these were significantly higher in elderly ( > 65 years, p = 0.004), advanced T stage (p = 0.022). Renal impairment was developed in 19 patients (18.8%) showing a tendency related to age (p = 0.084). Both ENT and renal toxicities were not associated with the dose of radiation or cumulative cisplatin (Table). Conclusions: TPF followed by CCRT is an effective treatment scheme for locally advanced NPC. However, long term complications in ENT were considerable in elderly, advanced T stage. Therefore, the close follow up and management for these complications should be performed. Also optimal treatment approach for elderly patients is needed to prevent acute as well as chronic complications.