Consolidative radiation therapy (RT) is of prime importance for early-stage Hodgkin lymphoma (HL) management since it significantly increases progression-free survival (PFS). Proton therapy reduces radiation exposure to several OARs, including cardiac substructures which should significantly reduce late radiation-induced toxicities and secondary cancers.

This review examined the current literature of proton therapy for mediastinal HL treatment and pointed out that the clinical benefits of proton therapy is still uncertain based on the available data which is lack of long term follow-up for late toxicity. There is a need for larger population HL proton therapy studies to evaluate long-term adverse events and propose toxicity prediction models.

While randomized controlled trials for HL proton therapy are probably unrealistic, the development of clinical registries might undoubtedly help to elucidate current uncertainties concerning this promising technique.