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 structure of bones and joints.
NOTE: Hematologic injury is handled separately (above).
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.
Late Complications
Grade 0: no change
Fatality (Grade 5) would be unlikely from irradiation injury to bone or joint.
|
Bone Injury |
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
growth retardation |
none |
present |
complete arrest bone growth |
NA |
|
pain and tenderness |
none |
moderate |
severe |
NA |
|
bone consistency |
reduced density |
irregular sclerosis |
dense bone sclerosis |
necrosis, spontaneous fracture |
|
Joint Injury |
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
stiffness |
mild |
moderate |
severe |
NA |
|
limitation in movement |
slight |
moderate |
severe |
complete fixation |
|
joint pain |
slight |
intermittent or moderate |
severe |
NA |
|
other |
NA |
NA |
NA |
necrosis |
Specialty: Hematology Oncology, Surgery, orthopedic
ICD-10: ,
