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 pharynx and esophagus.
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 |
|
dysphagia or odynophagia |
mild |
moderate |
severe |
NA |
|
therapy |
may require topical anesthetic or non-narcotic analgesic |
may require narcotic analgesic |
NA |
NA |
|
diet |
may require soft diet |
may require puree or liquid diet |
require nasogastric feeding tube, IV fluids or hyperalimentation |
NA |
|
other |
NA |
NA |
dehydration or weight loss (> 15% from baseline) |
complete obstruction, ulceration, perforation or fistula |
Grade 5: death directly due to radiation effect
Late Complications
Grade 0: no change from baseline
|
Injury |
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
fibrosis |
mild |
|
severe |
NA |
|
swallowing |
slight difficulty in swallowing solids |
unable to take solid food normally; swallows semi-solid food |
only able to swallow liquids |
NA |
|
pain on swallowing |
none |
NA |
may have pain on swallowing |
NA |
|
other |
NA |
dilatation may be indicated |
dilatation may be required |
necrosis, perforation or fistula |
Grade 5: death directly due to radiation late effect
Specialty: Hematology Oncology, Gastroenterology
ICD-10: ,
