AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO026030029
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ORIGINAL RESEARCH ARTICLE

First retrospective dosimetric comparison of three radiotherapy techniques for nasopharyngeal carcinoma in Mauritania: 3D-CRT, 3D-CRT+E, and VMAT

Zeinebou Yacoub Cheikh Sidiya1,2,3 ,  Ahmedou Seyed1 ,  Ahmedou Tolba1 ,  Cheibetta Moussa1 ,  Leila Ounalli3,4*
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1 Department of Radiation Therapy, National Oncology Center, Nouakchott, Mauritania
2 Department of Biophysics, Higher Institute of Medical Technologies of Tunis, University of Tunis El Manar, Tunis, Tunisia
3 Research Laboratory on Energy and Matter for Nuclear Science Development, National Center for Nuclear Sciences and Technology, Technopark Sidi Thabet, Ariana, Tunisia
4 Department of Nuclear Safety, National Center for Nuclear Sciences and Technology, Technopark Sidi Thabet, Ariana Governorate, Tunisia
EJMO, 026030029 https://doi.org/10.36922/EJMO026030029
Received: 15 January 2026 | Revised: 8 March 2026 | Accepted: 16 March 2026 | Published online: 24 April 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Radiotherapy remains the primary therapeutic option for nasopharyngeal carcinoma (NPC). The choice of technique, however, directly influences tumor control and the preservation of healthy tissues.

Objective: This study aims to evaluate the dosimetry outcomes of three approaches: three-dimensional conformal radiation therapy (3D-CRT), 3D-CRT with electron boost (3D-CRT+E), and volumetric-modulated arc therapy (VMAT), as implemented at the National Oncology Center in Nouakchott, Mauritania.

Methods: Sixty-seven patients with NPC were included. For each patient, three plans (3D-CRT, 3D-CRT+E, and VMAT) were available or retrospectively reconstructed from archived CT datasets, yielding 201 plans for paired dosimetric comparison. Treatment planning was performed using Eclipse 3.0, with delivery on the Clinac 2100 for 3D-CRT and 3D-CRT+E, and Halcyon 3.0 for VMAT. Dosimetric parameters, including dose coverage (D95%), conformity index, homogeneity index, and doses to organs at risk (OARs), were evaluated. Isodose volumes (ISO30, ISO20, ISO10) were also assessed. Statistical analyses were performed using the Wilcoxon test.

Results: VMAT exhibited significantly higher dose coverage (D95%, p = 0.01) and demonstrated optimal homogeneity and conformity (p < 0.001) compared to 3D-CRT and 3D-CRT+E. It also reduced radiation exposure to critical OARs (p < 0.008) and lowered isodose volumes (ISO30, ISO20, ISO10, p = 0.0187), thereby enhancing healthy tissue sparing.

Conclusion: The findings confirm that VMAT offers clear dosimetric advantages over 3D-CRT and 3D-CRT+E, consistent with international evidence. The novelty of this study lies in its demonstration, for the first time in Mauritania, that VMAT can be successfully implemented in routine practice. By validating global standards in a local context, this study supports the integration of VMAT into national treatment protocols and highlights its potential to improve clinical outcomes for patients with NPC.

Keywords
Conformity index
Dose coverage
Homogeneity index
Nasopharyngeal cancer
Volumetric-modulated arc therapy
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest
The authors declare they have no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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