Abstract: Objective To compare the efficacy and toxicity between docetaxel （TXT）and cisplatin（DDP） in concurrent chemoradiotherapy of locally advanced nasopharyngeal carcinoma. Methods In this study，72 patients with locally advanced nasopharyngeal carcinoma from March 2015 to June 2016 were enrolled. According to the treatment regimes，27 patients received TXT （75 mg/m2） on day 1 with 21 days as a cycle and 45 patients received DDP 40 mg/m2 on day 1 every 7 days or 80 mg/m2 on day 1 with 21 days as a cycle. Three dimensional conformal radiotherapy with total dose of 70 Gy/35 f was used for radiotherapy. Response to chemoradiotherapy was assessed by RECIST criteria 1.1 at 3 months after treatment and toxicity was evaluated according to Common Terminology Criteria for Adverse Events （CTCAE） v4.0 and RTOG/EORTC acute radiation morbidity scoring criteria. Results Except one patient in DDP group, the remaing patients were evaluated for the short-term efficacy. The complete remission rates of primary focus were 66.7% and 81.8% in TXT and DDP group. The complete remission rates of lymph gland were 81.5% and 95.5% in TXT and DDP group. There was no significant difference in short-term efficacy between TXT group and DDP group（P>0.05）. The incidences of grade 3-4 leucopenia and neutropenia in TXT group were significantly higher than those in DDP group（48.1% vs. 22.2%，P=0.022； 37.0% vs. 15.6%，P=0.048）. The incidence of anemia was significantly higher in TXT group as compared with DDP group （80.0% vs. 53.3%，P=0.039）. The incidence of grade 3-4 mucositis was significantly lower in TXT group as compared with DDP group（29.6% vs. 57.8%，P=0.028）. The occurrence of throat pain in TXT group was later than in DDP group［（11.70±3.930） d vs.（9.38±3.453） d，P=0.011］. The incidence of grade 2-3 nausea or vomiting was statistically significantly lower in TXT group than in DDP group （22.2% vs. 48.9%， P=0.028）. Conclusion There was the similar short-term curative effect for TXT and DDP during concurrent chemotherapy in locally advanced nasopharyngeal carcinoma. TXT had lighter mucositis and gastrointestinal reaction，but the incidence of myelosuppression was higher in TXT. Patients were well tolerated with TXT. TXT can be used to replace cisplatin as one of the chemotherapy drugs for locally advanced nasopharyngeal carcinoma.