Background: The aim of this study was to build nomograms to predict local 
recurrence (LR) and regional recurrence (RR) in patients with nasopharyngeal 
carcinoma (NPC) underwent intensity-modulated radiation therapy (IMRT). Patients 
and Methods : A total of 1811 patients with non-metastatic NPC treated with IMRT 
(with or without chemotherapy) between October 2009 and February 2012 at our 
center were involved for building the nomograms. Nomograms for LR-free rate and 
RR-free rate at 3- and 5- year were generated as visualizations of Cox 
proportional hazards regression models, and validated using bootstrap 
resampling, estimating discrimination and calibration. Results: With a median 
follow up of 49.50 months, the 3- and 5- year LR-free rate were 95.43% and 
94.30% respectively; the 3- and 5- year RR-free rate were 95.94% and 95.41% 
respectively. The final predictive model for LR included age, the 
neutrophil/leukocyte ratio (NWR), pathological type, primary gross tumor volume, 
maxillary sinus invasion, ethmoidal sinus invasion and lacerated foramen 
invasion; the model for RR involved NWR, plasma Epstein-Barr virus (EBV) DNA 
copy number, cervical lymph node volume and N category. The models showed fairly 
good discriminatory ability with concordance indices (c-indices) of 0.76 and 
0.74 for predicting LR and RR, respectively, as well as good calibration. The 
proposed stratification of risk groups based on the nomograms allowed 
significant distinction between Kaplan-Meier curves for LR and RR. Conclusions: 
The proposed nomograms resulted in more-accurate prognostic prediction for LR 
and RR with a high concordance, hence to inform patients with high risk of 
recurrence on more aggressive therapy. The prognostic nomograms could better 
stratify patients into different risk groups.