title: Evidence on effectiveness of intensity-modulated radiotherapy versus 2-dimensional radiotherapy in the treatment of nasopharyngeal carcinoma: Meta-analysis and a systematic review of the literature.
abstract: Current management of nasopharyngeal carcinoma (NPC) uses radiotherapy (RT) as the curative treatment modality. Radiation delivery techniques for NPC can be achieved using 2D conventional RT or intensity-modulated radiotherapy (IMRT).
  
  
  
  A systematic review and meta-analysis of the literature was undertaken to assess the effectiveness of IMRT versus 2D conventional RT in primary treatment of NPC.
  
  
  
  IMRT showed better results than 2D conventional RT in terms of local control, regional control, and overall survival, but when stratified, only in T4, N2, and stage III were the differences that were seen. Objective saliva measurements and physician-graded xerostomia were better in IMRT. However, patient-reported xerostomia showed minimal improvement only in IMRT. The evidence of superiority of IMRT over 2D conventional RT is not clear.
  
  
  
  In the absence of more clinical data demonstrating the superiority of IMRT in the treatment of nasopharyngeal carcinoma, 2D conventional RT seems to be a reasonable treatment option, especially in limited resource settings. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2130-E2142, 2016.
authors.affiliation: Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Espana, Manila, Philippines.
authors.forename: Jayson
authors.initials: J
authors.lastname: Co
authors.affiliation: Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Espana, Manila, Philippines.
authors.forename: Michael Benedict
authors.initials: MB
authors.lastname: Mejia
authors.affiliation: Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Espana, Manila, Philippines.
authors.forename: Janine Margarita
authors.initials: JM
authors.lastname: Dizon
mesh_terms: D002277:Carcinoma / Q000532:radiotherapy*; D006801:Humans; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D016896:Treatment Outcome; D014987:Xerostomia / Q000453:epidemiology
keywords: 2D radiotherapy; intensity-modulated radiotherapy; nasopharyngeal carcinoma (NPC); oncologic outcome; xerostomia