8.1 - Grading Systems For Early Effects
What grading system is used for acute effects in your department?
There are several commonly used grading systems for early effects, which all share similar features. Commonly used grading systems rate a reaction from Grade 0 (no reaction) to Grade 5 (death from reaction). The grading systems in common use are:
- RTOG/EORTC
- WHO
The general format of effects is shown in the table below:
| Grade 0 | Grade 1 | Grade 2 | Grade 3 | Grade 4 | Grade 5 |
|---|---|---|---|---|---|
| No reaction | Mild reaction, minimal or no symptoms | Symptomatic reaction, managed as outpatient | Severe reaction requiring admission | Life threatening reaction | Death due to early effect |
For skin:
| Grade 0 | Grade 1 | Grade 2 | Grade 3 | Grade 4 | Grade 5 |
|---|---|---|---|---|---|
| No reaction | Erythema, dry desquamation | Patchy moist desquamation | Confluent moist desquamation | Skin necrosis | Death due skin toxicity |
For oral mucousitis:
| Grade 0 | Grade 1 | Grade 2 | Grade 3 | Grade 4 | Grade 5 |
|---|---|---|---|---|---|
| No reaction | Erythema of the mucosa | Patchy mucousitis | Confluent mucousitis | Mucousitis preventing all oral intake | Death due mucousitis |
