Objective To investigate the curative potential of concurrent cisplatin radiation and chemotherapy in the management of locally advanced nasopharyngeal cancer and to examine the features of magnetic resonance imaging (MRI) imaging. Methods One hundred and ten patients with advanced nasopharyngeal cancer who were diagnosed and treated at our hospital between January 2018 and January 2020 were randomly assigned to either a research group of 45 cases or a control group of 45 cases using a random number table. All patients in both groups received radiation and chemotherapy at the same time, but the study group also received cisplatin. Both groups were compared for the treatment's efficacy and the incidence of side effects. Before and after therapy, MRI scans were performed on both groups. The imaging changes before and after treatment and the mean slopes of relapsers and fibrosis were compared. Results Compared to the control group's ORR of 77.78%, the research group's ORR of 91.11% was statistically and practically significant (P<0.05). In terms of adverse responses, there was no discernible difference between the two groups (P>0.05). Tumor area was reduced, the border was reasonably clear, the signal on T2WI was low, the signal of the diffusion weighted imaging (DWI) sequence was low, and the signal on T1WI was low after treatment, as shown by MRI. The mean slope of the recurrence group was much greater than that of the fibrosis group in a study of 90 patients with nasopharyngeal cancer, and the difference was statistically significant (P<0.05). Conclusion Locally advanced nasopharyngeal cancer responds well to concurrent cisplatin radiation and chemotherapy, and prognosis can be determined using MRI imaging analysis of hismic features.