OBJECTIVE To observe the clinical effect of Biafine cream in preventing and treating radioactive skin destruction of nasopharyngeal carcinoma (NPC) patients induced by synchronized intensity-modulated radiotherapy and chemotherapy. METHODS The patients were treated with Varian-600CD 6 MV X-ray three-dimensional (3D) conformal intensity-modulation radiotherapy (IMRT), with a 120-blade multiple leaf-blade grating and in combination with synchronal Capecitabine chemotherapy. Fifty-one patients undergoing radiotherapy and chemotherapy were randomized into 2 groups: 25 in the treatment group received a Biafine cream application following the first radiotherapy and / or chemotherapy, while the other 26, served as controls. They received no application of the cream, but only followed normal procedures for conventional radiotherapy and health education. RESULTS The rate of the skin-reaction was 100% in the patients of both groups. A mild radiation reaction (grade-Ⅰ and Ⅱ) occurred as follows: 88.0% (22/25 cases) in the treatment group and 57.7% (15/26 cases) in the control group. A grade-Ⅲ radiation reaction developed in 12.0% (3/25 cases) in the treatment group, and 42.3% (11/26 cases) in the controls. There was a significant difference, P〈0.01 between the two groups. Concerning the degree of the skin response before the patients received a dose of 40 Gy, the radiation reaction emerged in 32.0% (8/25) of the cases in the treatment group, and in 96.2% (25/26) of the cases of the control group. CONCLUSION Biafine cream can effectively reduce the acute irradiation or chemotherapy-induced dermal injury. It can alleviate the patients' suffering, improve their quality of life, and can ensure less injurious radiotherapy.