RTOG/EORTC Criteria for Lung Complications to 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 pulmonary complications of radiation therapy.

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 signs or symptoms

Injury	Grade 1	Grade 2	Grade 3	Grade 4
symptoms	asymptomatic or mild symptoms	moderate	clinical or radiologic evidence of acute pneumonitis	severe respiratory insufficiency
cough	may have dry cough	persistent cough requiring narcotic, antitussive agents	severe cough unresponsive to narcotic, antitussive agent	NA
dyspnea	may have dyspnea on exertion	dyspnea with minimal effort but not at rest	dyspnea at rest	NA
other	NA	NA	intermittent oxygen or steroids may be required	need for continuous oxygen or assisted ventilation

Grade 5: death directly due to radiation effect

Late Complications

Grade 0: no signs or symptoms

Injury	Grade 1	Grade 2	Grade 3	Grade 4
symptoms	asymptomatic or mild symptoms (dry cough)	moderate	severe symptomatic fibrosis or pneumonitis	severe respiratory insufficiency
radiographic appearance	slight	patchy	dense changes	NA
other	NA	low grade fever	NA	need for continuous oxygen or assisted ventilation

Grade 5: death directly due to radiation late effect

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Description

Specialty

ICD-10