Abstract: Objective 　To evaluate the efficacy and toxicity of gemcitabine in combination with carboplatin as second-line treatment in the patients with advanced nasopharyngeal carcinoma (NPC) . Methods 　Eligibale patients with advanced NPC failed to previous cisplatin-based chemotherapy were analysed retrospectively. These patients had a performance status of 0 to 2, and adequate liver or renal function, as well as measurabale disease. Chemotherapy was administered with gemcitabine, 1, 000mg/ m², int ravenously infusion for 30 minutes in d1 and d8, followed by carboplatin, 400mg/ m², int ravenously infusion for 2 hours in day 1 ;treatment was repeated every 21 days. Efficacy and toxicity would be evaluated after the completion of two cycles of chemoyherapy. Results 　A total of 32 patients t reated in the period of January, 2004 to March, 2007 were involved in this study. Complete remission ( CR) was observed in 4 patients (12. 5 %), 16 patients (50. 0 %) achieved partial remission, giving a total response rate of 62. 5 %. 8 patients achieved a stable status, 4 patients suffered from progressive disease. Median time to progression ( TTP) was 4. 5 months. . Hematological toxicities were the predominant side effects with grade 3/ 4 leukopenia, thrombocytopenia were observed in 43. 6 %, 21. 8 %of patient s, respectively, 4 febrile neut ropenia occurred. Non-hematological toxicity was mild. Conclusion 　The combination of gemcitabine and carboplatin showed a promising result s as second-line chemotherapy in patients with advanced NPC, which merits the further study in a prospective clinical trial.