Treatment Outcomes in Nasopharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy Versus 3D-Conformal Radiotherapy Techniques: A Single-Center Experience in a Developing Country.

BACKGROUND: Radiotherapy (RT) is the primary treatment for non-metastatic nasopharyngeal cancer (NPC). While intensity-modulated RT (IMRT) is preferred in wealthy regions, three-dimensional conformal RT (3D-CRT) remains common in resource-limited settings. This study evaluated IMRT versus 3D-CRT for NPC, focusing on survival, tumor control, and toxicities. METHODS: This retrospective cohort study, performed at the Cancer Institute of Iran from 2007 to 2024, assessed individuals with non-metastatic nasopharyngeal carcinoma (NPC). Demographic data, treatment details, recurrence rates, metastasis, and survival information were obtained from medical records and follow-up telephone interviews. Complications associated with treatment were classified according to Common Terminology Criteria for Adverse Events v5.0 (2017). Statistical studies were conducted utilizing R software, accompanied with a p-value. RESULTS: A total of 176 patients were enrolled, with 124 receiving 3D-CRT and 52 receiving IMRT. IMRT was associated with a significantly reduced incidence of dysphagia and with reduced severity of trismus, dysphagia, xerostomia, and hearing impairment. No significant differences were observed in the incidence or severity of neck stiffness or oral mucositis between the two groups. Concerning treatment results, no statistically significant differences were seen in disease-free survival or metastasis-free survival. The overall survival exhibited a non-significant trend favoring IMRT. CONCLUSION: IMRT markedly diminishes several treatment-associated complications in comparison to 3D-CRT; however, it does not provide a definitive survival advantage yet. Extended follow-up and prospective investigations are necessary to elucidate the disparities in long-term efficacy between the two approaches. TRIAL REGISTRATION: Not applicable.