Common Toxicity Criteria (CTC) for Renal and Genitourinary Adverse Events Associated with Cancer Therapy

bladder spasm

none

0

mild symptoms, not requiring intervention

1

symptoms requiring antispasmodic agents

2

severe symptoms requiring narcotic analgesic

3

serum creatinine

within normal limit

0

> upper limit of normal (ULN) and <= 1.5 times ULN

1

> 1.5 times ULN and <= 3.0 times ULN

2

> 3 times ULN and <= 6.0 times ULN

3

> 6 times ULN

4

dysuria

none

0

mild symptoms not requiring an intervention

1

symptomatic, relieved with therapy

2

symptoms not relieved with therapy

3

fistula

none

0

requires intervention

3

requires surgical repair

4

hemoglobinuria

absent

0

present

1

incontinence

none

0

with coughing, sneezing, etc.

1

spontaneous, with some control

2

no control (in the absence of a fistula)

3

operative injury

none

0

injury to bladder with primary repair

2

sepsis, fistula, or obstruction requiring secondary surgery; loss of one kidney; injury requiring anastomosis or re-implantation

3

septic obstruction of both kidneys or vesicovaginal fistula requiring diversion

4

proteinuria

< 0.15 g per 24 hours

0

0.15 to 1.0 g per 24 hours (or 1+ on dipstick)

1

1.01 to 3.5 g per 24 hours (or 2-3+ on dipstick)

2

> 3.5 g per 24 hours (4+ on dipstick)

3

nephrotic syndrome

4

renal failure

none

0

requires dialysis but reversible

3

requires dialysis and irreversible

4

ureteral obstruction

none

0

unilateral, not requiring surgery

1

bilateral, not requiring surgery

3

requires stent, nephrostomy tube, or surgery

4

urinary electrolyte wasting

none

0

asymptomatic, not requiring therapy

1

mild, reversible and manageable with oral replacement

2

reversible but requires IV replacement

3

irreversible, requiring continuous replacement

4

urinary frequency or urgency

normal

0

increase in frequency or nocturia up to 2 times normal

1

increase more than 2 times normal but less than hourly

2

hourly or more frequently with urgency, or requires catheter

3

urinary retention

none

0

hesitancy or dribbling but no significant residual urine; retention occurs during the immediate post-operative period

1

hesitancy requiring medication or occasional in/out catheterization, or operative bladder atony requiring indwelling catheter beyond immediate postoperative period but for less than t weeks

2

requires frequent in/out catheterization (4 or more times per week) or urological intervention (TURP, suprapubic tube, urethrotomy)

3

bladder rupture

4

urine color change

normal

0

asymptomatic change in color (not due to bilirubin, hematuria, or concentration)

1

vaginitis

none

0

mild, not requiring therapy

1

moderate, relieved with therapy

2

severe, not relieved by therapy, or ulceration not requiring surgery

3

ulceration requiring surgery

4

other renal or GU adverse event

none

0

mild

1

moderate

2

severe

3

life-threatening or disabling

4