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Radiation therapy is part of the treatment for most people with Hodgkin lymphoma. This type of treatment uses high-energy rays, or particles, to destroy cancer cells. It's especially useful when Hodgkin lymphoma is only in one part of the body.
Radiation therapy can be effective at killing Hodgkin lymphoma cells. The goal is to use lower doses of radiation because it can cause long-lasting side effects.
Radiation therapy can be used by itself to treat some cases of early-stage NHLPL.
To treat Hodgkin lymphoma, doctors use a machine to send strong beams of radiation to the cancer. This is called external beam radiation.
Many doctors prefer this newer approach to radiation therapy when treating Hodgkin lymphoma. In ISRT, radiation is aimed only at the lymph nodes that originally contained lymphoma, as well as any nearby areas the cancer extended into.
This shrinks the size of the treatment area, or field. It helps spare nearby normal tissues and organs from getting radiation.
This was the preferred form of radiation therapy for Hodgkin lymphoma in the past, but it's now largely being replaced by ISRT.
In this technique, only the lymph node regions that have Hodgkin lymphoma are treated, but this includes larger treatment areas than ISRT does. This can increase the risk of radiation reaching nearby organs.
Radiation is usually given 5 days a week for a few weeks. Each session is quick. It is a lot like getting an x-ray, but with stronger radiation. The setup may take longer than the treatment itself. It doesn’t hurt, but young children might need medicine to help them stay still.
Before treatment starts: The care team does a planning session called a simulation. They use imaging tests like CT or PET scans to decide where to aim the radiation and how much to give.
During treatment: You may lie in a mold or use a headrest to help you stay in the same position each time. Sometimes you’ll be asked to hold your breath for a few seconds. This helps focus the radiation on the cancer and protect healthy body parts.
Keeping healthy organs safe: Modern imaging lets doctors target the lymphoma very accurately. This helps avoid harming nearby healthy organs like the lungs, heart, and spinal cord. Since lymph nodes are all over your body, Hodgkin lymphoma can grow near important organs, muscles, and nerves. It's very important to aim the radiation carefully.
The side effects of radiation therapy for Hodgkin lymphoma depend on where the radiation is aimed.
Some possible short-term effects include:
Radiation given to several areas, especially after chemotherapy, can lower blood cell counts and increase the risk of infections.
Radiation therapy can also have long-lasting effects, including:
To reduce the risk of side effects, your cancer care team will carefully calculate the exact dose of radiation you need and aim the beams as accurately as possible. They might also place shields over nearby parts of the body to protect them from the radiation.
To help preserve fertility in girls and young women, the ovaries are sometimes moved out of the way with minor surgery before radiation.
If you or your child is getting radiation therapy, be sure to talk to your cancer care team about the possible long-term side effects. Hodgkin lymphoma can be cured, and long-term side effects are a very real concern.
For more information, see After Hodgkin Lymphoma Treatment.
To learn more about how radiation is used to treat cancer, see Radiation Therapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Dabaja BS, Hoppe BS, Plastaras JP, et al. Proton therapy for adults with mediastinal lymphomas: the International Lymphoma Radiation Oncology Group guidelines. Blood 2018;132:1635-1646.
Figura N, Flampouri S, Mendenhall NP, et al. Importance of baseline PET/CT imaging on radiation field design and relapse rates in patients with Hodgkin lymphoma. Adv Radiat Oncol 2017;2:197-203.
National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Hodgkin Lymphoma, Version 2.2025 -- Jan 30, 2025. Accessed at www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf on July 10, 2025.
Rechner LA, Maraldo MV, Vogelius IR, et al. Life years lost attributable to late effects after radiotherapy for early stage Hodgkin lymphoma: The impact of proton therapy and/or deep inspiration breath hold. Radiother Oncol 2017;125:41-47.
Specht L, Yahalom J, Illidge T, et al. Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG). Int J Radiat Oncol Biol Phys 2014;89:854-862.
Xu YG, Qi SN, Wang SL, et al. Dosimetric and clinical outcomes with intensity modulated radiation therapy after chemotherapy for patients with early-stage diffuse large B-cell lymphoma of Waldeyer ring. Int J Radiat Oncol Biol Phys 2016;96:379-386.
Last Revised: October 6, 2025
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