Abstract: Objective : A prospective study to compare the efficacy and safety profile of patients treated with standard radiotherapy versus the same radiotherapy associated with weekly Oxaliplatin in patients with locoregionally advanced nasopharyngeal carcinoma. Methods : From January 2001 to February 2002, 77 patients with loco-regional advanced NPC (Ⅲ, Ⅳa) were randomized into either the group of simple radiotherapy (RT arm, 38 patients) or the synchronous chemo-radiotherapy (CCRT arm, 39 patients). RT was administered with the same way in both arms. CCRT with Oxaliplatin 70 mg/m² weekly was given for six doses from the first day of radiotherapy. Results : All patients were eligible for toxicity and response analysis. Compliance with the protocol treatment was excellent with 97% patients completing all planned doses of oxaliplatin and RT, and the lack of high-grade toxicity was observed. After a median follow-up of 24 months, the 2-year overall survival (OS) rates were 100% for the CCRT arm and 76% for the RT arm (P=0.02). The 2-year metastasis-free survival (MFS) rate was 91% for the CCRT arm versus 76% for the RT arm (P=0.04). The 2-year relapse-free survival (RFS) rate was 95% for the CCRT arm versus 83% for the RT arm (P=0.11), there was a significant difference in overall survival, and metastasis-free survival in favor of the CCRT arm. Conclusion : CCRT with weekly oxaliplatin is well tolerable and improves the OS rate and MFS rate in patients with locoregionally advanced NPC. Therefore, further randomized trails including oxaliplatin are warranted.