Objective: This study aims to compare intensity-modulated radiotherapy (IMRT) and two- dimensional conventional radiotherapy (2DCRT) considering treatment response, treatment compliance, and toxicity in nasopharyngeal cancer (NPC) patients.

Materials and Methods: A total of 78 NPC patients admitted between January 1999– December 2013 were retrospectively evaluated for local control (LC), treatment compliance, and toxicity. Of these, 55 (70.5%) were treated with 2DCRT, and 23 (29.5%) were treated with IMRT.

Results: The median follow-up time was 34.1 months (range, 3.2–202.84). Xerostomia was the most common acute toxicity in both the 2DCRT (41, 77.4%) and IMRT (18, 78.3%) groups. The most common late toxicity occurred in 28 (51.9%) patients in the former was xerostomia, while that in the latter was soft tissue fibrosis in 13 (56.6%) patients. No differences between these treatments were observed considering acute or late toxicity. In the former, 23 patients (41.8%) interrupted the treatment, while in the latter only 4 patients (17.4%) interrupted it. This difference was statistically significant. Considering treatment response, no significant difference was noted.

Conclusion: IMRT was better than 2DCRT for treatment of NPC considering treatment compliance, toxicity, and tumor response; however, prospective studies with more patients are needed for confirmation.