Objective:To compare the efficacy and adverse reactions between gemcitabine+cisplatin regimen and fluorouracil+cisplatin regimen in the treatment of advanced nasopharyngeal carcinoma (NPC).Methods:The Cochrane Library,MEDLINE,EMbase,CBM and CNKI were searched for related articles published before 2009.Manual searching and additional searching were also performed.The quality of each included studies was evaluated by 2 independent oncologists and analyses of homogeneous property of the studies were done by RevMan 5.0 software.Results:Four studies were enrolled in our study,including 283 patients with NPC.Meta-analyses showed that the 1-year- and 3-year-survival rates of gemcitabine+cisplatin regimen were similar to those of fluorouracil+cisplatin regimen (Z=0.89,P=0.37),(Z=1.70,P=0.09),but gemcitabine+cisplatin regimen had significantly higher remission rate (Z=2.34,P=0.02) and slighter myelosuppression and gastrointestinal reactions (Z=2.47,P=0.01),(Z=3.20,P=0.001),(Z=2.19,P=0.03).Conclusion:Gemcitabine+cisplatin regimen has equivalent efficacy and slighter adverse effects compared with fluorouracil+cisplatin regimen in treatment of advanced nasopharyngeal carcinoma.