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 ears.
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/Chronic Complications
Grade 0
• none (no change from baseline)
Injury
Grade 1
Grade 2
Grade 3
Grade 4
external otitis
mild, not requiring medication
moderate, requires topical medication
severe
severe
hearing
audiogram unchanged from baseline
hypoacusis on testing only
symptomatic hypoacusis
deafness
other
NA
serous otitis medius
tinnitus, not drug-related
NA
External otitis
• mild: may show erythema, pruritis, dry desquamation
• severe: may show discharge or moist desquamation
Note: Death to acute radiation effects (Grade 5) would not be expected with radiation to the ears.
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