Should chemoradiotherapy to primary and neck be offered to patients with Stage IVC nasopharyngeal carcinoma with limited osseous disease?

Yes. Please refer to the recent small phase III randomized trial: You et al., PMID 32701129.

Anecdotally, I have treated an Asian patient with EBV-associated NPC who had a single sternal met at presentation with definitive chemoxrt (no induction) who is is ~7 years post treatment and is NED.