This retrospective study included consecutive patients treated with platinum-containing first-line chemotherapy followed by LRRT for de novo metastatic NPC between January 2008 and December 2015 at the Sun Yat-sen University Cancer Center. Inclusion criteria for the current study consisted of treatment-naïve histologically confirmed NPC with metastatic disease at the time of presentation, available TNM classifications, without previous or synchronous malignancies at other sites, platinum-based chemotherapy as first-line treatment at least for two cycles followed by LRRT, and measurable primary and metastatic lesions assessed and monitored at least at baseline and after first-line chemotherapy. The study population was divided into the training and validation sets aiming at a ratio of 2 : 1. Finally, 152 (62.3%) patients treated between 2008 and 2013 comprised the training set for model development, whereas 92 (37.7%) patients treated at a later time (2014 to 2015) were applied to validation. This study obtained approval from the Research Ethics Committee of Sun Yat-sen University Cancer Center (registration number 2020-FXY-277). Informed consent was waived due to the retrospective nature of this study and the anonymous processing of patient data. All personal data were anonymized before analysis.

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