Objective To investigate the survival data and acute toxicities in patients with locoregionally advanced nasopharyngeal carcinoma who receive intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy using nedaplatin plus 5-fluorouracil (PF) or taxol plus nedaplatin (TP). Methods A retrospective analysis was performed on the clinical data of 152 patients with stage Ⅲ or IVa nasopharyngeal carcinoma who were admitted to our hospital in 2009—2010. Of the 152 patients, 80 received IMRT with concurrent PF chemotherapy, and 72 received IMRT with concurrent TP chemotherapy;there were at least 2 cycles of concurrent chemotherapy in both groups. The Kaplan-Meier method was used to calculate the survival rates, and the log-rank test was used to analyze the survival difference;the chi-square test was used to compare the acute toxicities in the two groups. Results The follow-up rate was 100%. The 2-year relapse-free survival rate, distant metastasis-free survival rate, progression-free survival rate, and disease-specific death rate for the IMRT/PF group were 95%, 82%, 81%, and 13%, respectively, versus 97%, 83%, 79%, and 12% for the IMRT/TP group (χ²=0.03, 0.02, 0.62, and 0.22, P=0.861, 0.881, 0.431, and 0.638). The incidence rates of leukopenia (grade ≥3), neutropenia (grade ≥3),thrombocytopenia (grade ≥3), ALT elevation (grade ≥2), and oral mucositis (grade ≥3) for the IMRT/PF group were 33%, 23%, 14%, 8%, and 12%, respectively, versus 60%, 47%, 28%, 18%, and 25% for the IMRT/TP group (χ²=11.33, 10.29, 4.59, 3.94, and 3.94, P=0.001, 0.001, 0.032, 0.047, and 0.047). Conclusions Compared with IMRT with concurrent PF chemotherapy, IMRT with concurrent TP chemotherapy does not lead to significantly better survival and results in more acute toxicities in the patients with locoregionally advanced nasopharyngeal carcinoma.