RTOG/EORTC Criteria for Cardiac Complications from Irradiation

Description

The Radiation Therapy Oncology Group (RTOG) and the European Organization for Research on the Treatment of Cancer (EORTC) provide criteria for assessing the complications of radiation therapy affecting the heart.

Guidelines:

(1) Change in affected parameter is ascribed to radiation therapy and not underlying or concurrent disease.

(2) Considered acute if occurs from day 1 to 90; after day 90 considered late complication.

Acute Complications

Grade 0: none (no change from baseline)

Injury	Grade 1	Grade 2	Grade 3	Grade 4
symptoms	asymptomatic	symptomatic but no treatment required	symptomatic and responds to treatment	symptomatic unresponsive to medical treatment
EKG	minimal change	mild	moderate	severe
heart failure	none	mild	moderate	severe
angina	none	mild	moderate	severe
pericardium	minimal abnormalities	mild pericardial disease	moderate pericardial disease	severe pericardial disease

Grade 5: death caused by acute cardiac effects of the irradiation

Late Complications

Grade 0: no change from baseline

Injury	Grade 1	Grade 2	Grade 3	Grade 4
symptoms	asymptomatic or mild	moderate angina on effort	severe angina	NA
ECG	transient T wave inversion and ST wave changes	persistent abnormal T wave and ST wave changes; low QRS	multiple EKG changes	NA
pericardium	NA	mild pericarditis	pericardial effusion; constrictive pericarditis	tamponade; severe constrictive pericarditis
heart size	normal	normal	cardiac enlargement	NA
heart failure	NA	NA	moderate	severe
other	sinus tachycardia (> 110 beats per minute at rest)	NA	NA	NA

Grade 5: death caused by late cardiac effects of the irradiation

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Description

Specialty

ICD-10