This study reported outcomes of 21 pediatric patients with Hodgkin lymphoma treated with PT specifically to infradiaphragmatic targets to a total median dose of 21GyRBE over 14 fractions. With a median follow-up of 5 years, there was no local or marginal failures occurred and 5% patients experienced disease progression. Acute grade 1 toxicities included fatigue (59%) and anorexia (36%). Rates of acute G2 and G3+ toxicity were 18% and 0%, respectively. No secondary malignancies developed. Compared to photon radiotherapy, PT achieved significantly lower doses to the bowels, stomach, spleen, pancreatic tail, liver, kidneys, and pelvic bones.