The Common Toxicity Criteria (CTC) define adverse events following cancer therapy. It was designed for use in clinical trials of different therapeutic regimens.
Pulmonary complications:
(1) adult respiratory distress syndrome (ARDS)
(2) apnea
(3) carbon dioxide diffusion capacity (DL-CO)
(4) cough
(5) dyspnea (shortness of breath)
(6) FEV1
(7) hiccoughs (hiccups, singultus)
(8) hypoxia
(9) pleural effusion (non-malignant)
(10) pneumonitis, pulmonary infiltrates
(11) pneumothorax
(12) pulmonary fibrosis
(13) voice changes, stridor, larynx (hoarseness, loss of voice, laryngitis)
(14) other pulmonary complications
NOTE:
(1) Pleuritic pain is described under the CTC criteria for pain.
(2) Pulmonary embolism is described under the CTC criteria for cardiovascular (general) complications.
|
Complication |
Finding |
Grade |
|---|---|---|
|
ARDS |
absent |
0 |
|
|
present |
4 |
|
apnea |
none |
0 |
|
|
present |
3 |
|
|
requiring intubation |
4 |
|
carbon dioxide diffusion capacity |
>= 90% of pretreatment or normal value |
0 |
|
|
>= 75% and < 90% of pretreatment or normal value |
1 |
|
|
>= 50% and < 75% of pretreatment or normal value |
2 |
|
|
>= 25% and < 50% of pretreatment or normal value |
3 |
|
|
< 25% of pretreatment or normal value |
4 |
|
cough |
absent |
0 |
|
|
mild, relieved by non-prescription medication |
1 |
|
|
requires narcotic antitussive |
2 |
|
|
severe cough or coughing spasms, poorly controlled or unresponsive to treatment |
3 |
|
dyspnea |
normal |
0 |
|
|
dyspnea on exertion |
2 |
|
|
dyspnea at normal level of activity |
3 |
|
|
dyspnea at rest or requiring ventilatory support |
4 |
|
FEV1 |
>= 90% of pretreatment or normal value |
0 |
|
|
>= 75% and < 90% of pretreatment or normal value |
1 |
|
|
>= 50% and < 75% of pretreatment or normal value |
2 |
|
|
>= 25% and < 50% of pretreatment or normal value |
3 |
|
|
< 25% of pretreatment or normal value |
4 |
|
hiccoughs, hiccups |
none |
0 |
|
|
mild, not requiring treatment |
1 |
|
|
moderate, requiring treatment |
2 |
|
|
severe, prolonged and refractory to treatment |
3 |
|
hypoxia |
normal |
0 |
|
|
decreased oxygen saturation with exercise |
2 |
|
|
decreased oxygen saturation at rest, requiring supplemental oxygen |
3 |
|
|
decreased oxygen saturation requiring pressure support (CPAP) or assisted ventilation |
4 |
|
pleural effusion |
none |
0 |
|
|
asymptomatic and not requiring treatment |
1 |
|
|
symptomatic, requiring diuretics |
2 |
|
|
symptomatic, requiring oxygen or therapeutic thoracentesis |
3 |
|
|
life-threatening, requires intubation |
4 |
|
pneumonitis, pulmonary infiltrates |
none |
0 |
|
|
radiographic changes but asymptomatic, or symptomatic not requiring steroids |
1 |
|
|
radiographic changes and requiring steroids or diuresis |
2 |
|
|
radiographic changes and requiring oxygen |
3 |
|
|
radiographic changes and requiring assisted ventilation |
4 |
|
pneumothorax |
none |
0 |
|
|
no intervention required |
1 |
|
|
chest tube required |
2 |
|
|
sclerosis or surgery required |
3 |
|
|
life-threatening |
4 |
|
pulmonary fibrosis |
none |
0 |
|
|
radiographic changes but asymptomatic; symptoms not requiring steroids |
1 |
|
|
symptoms requiring steroids |
2 |
|
|
requires oxygen |
3 |
|
|
requires assisted ventilation |
4 |
|
voice change, stridor, larynx |
normal |
0 |
|
|
mild or intermittent hoarseness |
1 |
|
|
persistent hoarseness, but able to vocalize; may have mild to moderate laryngeal edema |
2 |
|
|
whispered speech; not able to vocalize; may have marked laryngeal edema |
3 |
|
|
marked dyspnea or stridor requiring tracheostomy or intubation |
4 |
|
other pulmonary complication |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
|
life-threatening or disabling |
4 |
Specialty: Hematology Oncology, Pulmonology
