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 |
Specialty: Hematology Oncology, Gastroenterology
ICD-10: ,