OBJECTIVE: The study was designed to appraise the locoregional recurrence 
patterns using conventional two-dimensional radiotherapy (2D-RT) and intensity 
modulated radiation therapy (IMRT) in nasopharyngeal carcinoma (NPC) in order to 
better establish the scenario of the modern radiotherapy and the duration of 
surveillance.
MATERIALS AND METHODS: We reviewed the institutional database to identify 
patients with pathologically confirmed, non-metastatic NPC who completed radical 
2D-RT or IMRT at our center from 2000 to 2011. We collected data on 
clinicopathologic features, treatments and outcomes. Statistical analyses were 
performed using SPSS 20.0 or STATASE 14.0.
RESULTS: The median follow-up was 60.1 months. Of 2315 patients, 1289 (53%) were 
treated with 2D-RT and 1026 (47%) with IMRT. IMRT group achieved better 
locoregional control rate, with the 5-year locoregional relapse-free survival 
(LRRFS) were 84.9% and 87.7% among patients received 2D-RT and IMRT, 
respectively (P = 0.050). IMRT was superior to 2D technique in terms of local 
relapse-free survival (LRFS) (88.4% vs 91.1%, P = 0.047) and the advantage was 
only significant in T3-4 subgroup (81.6% vs 90.2%, P = 0.000). Similar neck 
control rates were observed using different RT techniques. And the recurrence 
time appeared to be postponed by IMRT, with peaks accounting for the year 1.5 
and year 3-4 compared to which was predominant at the first two years using 
2D-RT in nature.
CONCLUSIONS: IMRT provided an improved LRRFS in overall stage and LRFS in 
advanced T stage for NPC compared with 2D-RT. Annual hazard of recurrence also 
changed with RT techniques.