RTOG/EORTC Criteria for Intestinal 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 intestines.

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: no change from baseline

Grade 5: fatal

Upper GI	Grade 1	Grade 2	Grade 3	Grade 4
anorexia and weight loss	<= 5% weight loss from pretreatment	> 5 and <= 15%	> 15%	NA
nausea and vomiting	mild, no therapy needed	anti-emetics	NG tube; parenteral support	NA
abdominal discomfort	mild, no therapy needed	analgesics	not controlled by drugs	surgery
bleeding	NA	NA	hematemesis melena	requires transfusion
other	NA	NA	distention	ileus obstruction perforation fistula

Lower GI	Grade 1	Grade 2	Grade 3	Grade 4
bowel movement	mild increase	requires anti-diarrheal meds	severe; requires parenteral support	NA
discomfort	present but no therapy needed	analgesics	not controlled by drugs	surgery
bloody or mucoid discharge	NA	no need for sanitary pads	sanitary pads needed	bleeding with transfusion
other	NA	NA	distention	obstruction perforation fistula

Late Complications

Grade 0: no change

Grade 5: fatal

GI Tract	Grade 1	Grade 2	Grade 3	Grade 4
diarrhea	mild	moderate	NA	NA
colic	mild	moderate	NA	NA
bowel movements	<= 5 per day	> 5 per day	NA	NA
bleeding	mild, intermittent	moderate	severe, requires surgery	NA
mucoid discharge	mild	moderate	severe	NA
other	NA	NA	obstruction	perforation fistula necrosis

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Description

Specialty

ICD-10