Radiation treatment techniques that increase the excess radiation dose to organs at risk (OARs) puts patients at risk of increased side effects, especially late toxicities, among adult lymphoma survivors. Minimizing radiation to OARs in adults patients with Hodgkin and non-Hodgkin lymphomas involving the mediastinum is the deciding factor for the choice of treatment modality.

Proton therapy may help reduce the radiation dose to the OARs and reduce toxicities, especially the risks of cardiac morbidity and second cancers. This modern guideline aims to identify the adult lymphoma patients who may derive the greatest benefit from proton, along with an analysis of the advantages and disadvantages of the proton treatment.