| Summary: | Umberto Ricardi,1 Maja V Maraldo,2 Mario Levis,1 Rahul R Parikh3 1Department of Oncology, University of Torino, Torino, Italy; 2Department of Clinical Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 3Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USACorrespondence: Mario LevisDepartment of Oncology, University of Torino, Via Genova 3, Torino 10125, ItalyTel +39 011 6334119Fax +39 011 6336614Email mario.levis@unito.itAbstract: The combination of brief chemo-radiotherapy provides high cure rates and represents the first line of treatment for many lymphoma patients. As a result, a high proportion of long-term survivors may experience treatment-related toxic events many years later. Excess and unintended radiation dose to organs at risk (particularly heart, lungs and breasts) may translate in an increased risk of cardiovascular events and second cancers after a few decades. Minimizing dose to organs at risk is thus pivotal to restrain the risk of long-term complications. Proton therapy, with its peculiar physic properties, may help to better spare organs at risk and consequently to reduce toxicities especially in patients receiving mediastinal radiotherapy. Herein, we review the physical basis of proton therapy and the rationale for its implementation in lymphoma patients, with a detailed description of the clinical data. We also discuss the potential disadvantages and uncertainties of protons that may limit their application and critically review the dosimetric studies comparing the risk of late complications between proton and photon radiotherapy.Keywords: proton therapy, lymphoma, Hodgkin, radiotherapy
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