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Subgroup analysis revealed that patients with GTVp ≤ 42.5 cc had better 5-year LRFS (98.7%vs 81.4%, P.001), 5-year DMFS (97.8%vs 82.5%, P.001), 5-year FFS (96.1%vs 65.4%, P.001), and 5-year OS (96.6%vs 78.2%, P.001) than patients with GTVp42.5 cc. However, additional chemotherapy showed no significant survival benefit in stratification analysis. Cervical node-negative NPC has a good prognosis in the IMRT era, and the primary tumor volume is the most important prognostic factor. Further exploration is needed to determine