OBJECTIVE： ?To observe clinical efficacy and safety of paclitaxel or 5-fluorouracil combined with nadaplatin in the treatment of advanced nasopharyngeal carcinoma （NPC）. METHODS： ?42 patients with advanced NPC were randomly divided into observation group and control group（n＝21）. 2 groups of patients were treated with radiotherapy. Observation group received chemotherapy of paclitaxel （135 mg/m2， d1） and nedaplatin （80 mg/m2， d 2-4）； control group received chemotherapy of 5-fluorouracil （500 mg/m2，d1-5） and nedaplatin （80 mg/m2， d1-3）； a treatment course lasted for 3 weeks， and both groups received 2 courses of treatment. Clinical efficacy， ?survival rate and ADR were observed in 2 groups. RESULTS： The overall response rate was 95.2％ in observation group and 90.5％ in control group， with no significant difference between 2 groups （P＞0.05）. The 3-year overall survival rate and progression-free survival rate were 81.0％ and 71.4％ in observation group and 76.2％ and 66.6％ in control group， with no significant difference （P＞0.05）. The incidence of nausea and vomiting in observation group were lower than in control group， while the incidence of oral mucosa inflammation was higher than control group， with statistical significance （P＜0.05）. CONCLUSIONS： The chemoradiotherapy of paclitaxel or 5-fluorouracil combined with nadaplatin have similar therapeutic efficacy for advanced NPC. ADR by chemoradiotherapy should be monitored closely and treated timely.