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(1) Background We compared the outcomes of patients with nasopharyngeal carcinoma treated with IMPT and VMAT. (2) Methods We performed a retrospective propensity score matching analysis (11) of patients treated with IMPT (years 2016-2018) and VMAT (2014-2018). Survival was estimated using the Kaplan-Meier method. Multivariate Cox proportional hazards regression analysis was used to identify the independent predictors of survival. Binary toxicity endpoint analyses were performed using a Cox model and logistic regression. (3) Results Eig