Category:CTCAE4 Respiratory, thoracic and mediastinal disorders
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| Adverse Event | Grade1 | Grade2 | Grade3 | Grade4 | Grade5 |
|---|---|---|---|---|---|
| Adult respiratory distress syndrome | - | - | Present with radiologic findings; intubation not indicated | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Allergic rhinitis | Mild symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated | - | - | - |
| Apnea | - | - | Present; medical intervention indicated | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Aspiration | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Altered eating habits; coughing or choking episodes after eating or swallowing; medical intervention indicated (e.g., suction or oxygen) | Dyspnea and pneumonia symptoms (e.g., aspiration pneumonia); hospitalization indicated; unable to aliment orally | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Atelectasis | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic (e.g., dyspnea, cough); medical intervention indicated (e.g., chest physiotherapy, suctioning); bronchoscopic suctioning | Oxygen indicated; hospitalization or elective operative intervention indicated (e.g., stent, laser) | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Bronchial fistula | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; tube thoracostomy or medical management indicated; limiting instrumental ADL | Severe symptoms; limiting self care ADL; endoscopic or operative intervention indicated (e.g., stent or primary closure) | Life-threatening consequences; urgent operative intervention with thoracoplasty, chronic open drainage or multiple thoracotomies indicated | Death |
| Bronchial obstruction | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic (e.g., mild wheezing); endoscopic evaluation indicated; radiographic evidence of atelectasis/lobar collapse; medical management indicated (e.g., steroids, bronchodilators) | Shortness of breath with stridor; endoscopic intervention indicated (e.g., laser, stent placement) | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Bronchial stricture | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic (e.g., rhonchi or wheezing) but without respiratory distress; medical intervention indicated (e.g., steroids, bronchodilators) | Shortness of breath with stridor; endoscopic intervention indicated (e.g., laser, stent placement) | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Bronchopleural fistula | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; tube thoracostomy or medical intervention indicated; limiting instrumental ADL | Severe symptoms; limiting self care ADL; endoscopic or operative intervention indicated (e.g., stent or primary closure) | Life-threatening consequences; urgent operative intervention with thoracoplasty, chronic open drainage or multiple thoracotomies indicated | Death |
| Bronchopulmonary hemorrhage | Mild symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated | Transfusion, radiologic, endoscopic, or operative intervention indicated (e.g., hemostasis of bleeding site) | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Bronchospasm | Mild symptoms; intervention not indicated | Symptomatic; medical intervention indicated; limiting instrumental ADL | Limiting self care ADL; oxygen saturation decreased | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Chylothorax | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; thoracentesis or tube drainage indicated | Severe symptoms; elective operative intervention indicated | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Cough | Mild symptoms; nonprescription intervention indicated | Moderate symptoms, medical intervention indicated; limiting instrumental ADL | Severe symptoms; limiting self care ADL | - | - |
| Dyspnea | Shortness of breath with moderate exertion | Shortness of breath with minimal exertion; limiting instrumental ADL | Shortness of breath at rest; limiting self care ADL | Life-threatening consequences; urgent intervention indicated | Death |
| Epistaxis | Mild symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated (e.g., nasal packing, cauterization; topical vasoconstrictors) | Transfusion, radiologic, endoscopic, or operative intervention indicated (e.g., hemostasis of bleeding site) | Life-threatening consequences; urgent intervention indicated | Death |
| Hiccups | Mild symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated; limiting instrumental ADL | Severe symptoms; interfering with sleep; limiting self care ADL | - | - |
| Hoarseness | Mild or intermittent voice change; fully understandable; self-resolves | Moderate or persistent voice changes; may require occasional repetition but understandable on telephone; medical evaluation indicated | Severe voice changes including predominantly whispered speech | - | - |
| Hypoxia | - | Decreased oxygen saturation with exercise (e.g., pulse oximeter <88%); intermittent supplemental oxygen | Decreased oxygen saturation at rest (e.g., pulse oximeter <88% or PaO2 <=55 mm Hg) | Life-threatening airway compromise; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Laryngeal edema | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; medical intervention indicated (e.g., dexamethasone, epinephrine, antihistamines) | Stridor; respiratory distress; hospitalization indicated | Life-threatening airway compromise; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Laryngeal fistula | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; tube thoracostomy or medical management indicated; limiting instrumental ADL | Severe symptoms; limiting self care ADL; endoscopic or operative intervention indicated (e.g., stent or primary closure) | Life-threatening consequences; urgent operative intervention indicated (e.g., thoracoplasty, chronic open drainage or multiple thoracotomies) | Death |
| Laryngeal hemorrhage | Mild cough or trace hemoptysis; laryngoscopic findings | Moderate symptoms; medical intervention indicated | Transfusion, radiologic, endoscopic, or operative intervention indicated (e.g., hemostasis of bleeding site) | Life-threatening airway compromise; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Laryngeal inflammation | Mild sore throat; raspy voice | Moderate sore throat; analgesics indicated | Severe throat pain; endoscopic intervention indicated | - | - |
| Laryngeal mucositis | Endoscopic findings only; mild discomfort with normal intake | Moderate discomfort; altered oral intake | Severe pain; severely altered eating/swallowing; medical intervention indicated | Life-threatening airway compromise; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Laryngeal obstruction | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic (e.g., noisy airway breathing), but causing no respiratory distress; medical management indicated (e.g., steroids); limiting instrumental ADL | Limiting self care ADL; stridor; endoscopic intervention indicated (e.g., stent, laser) | Life-threatening consequences; urgent intervention indicated | Death |
| Laryngeal stenosis | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic (e.g., noisy airway breathing), but causing no respiratory distress; medical management indicated (e.g., steroids) | Limiting self care ADL; stridor; endoscopic intervention indicated (e.g., stent, laser) | Life-threatening consequences; urgent intervention indicated | Death |
| Laryngopharyngeal dysesthesia | Mild symptoms; no anxiety; intervention not indicated | Moderate symptoms; mild anxiety, but no dyspnea; short duration of observation and or anxiolytic indicated; limiting instrumental ADL | Severe symptoms; dyspnea and swallowing difficulty; limiting self care ADL | Life-threatening consequences | Death |
| Laryngospasm | - | Transient episode; intervention not indicated | Recurrent episodes; noninvasive intervention indicated (e.g., breathing technique, pressure point massage) | Persistent or severe episodes associated with syncope; urgent intervention indicated (e.g., fiberoptic laryngoscopy, intubation, botox injection) | Death |
| Mediastinal hemorrhage | Radiologic evidence only; minimal symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated | Transfusion, radiologic, endoscopic, or elective operative intervention indicated (e.g., hemostasis of bleeding site) | Life-threatening consequences; urgent intervention indicated | Death |
| Nasal congestion | Mild symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated | Associated with bloody nasal discharge or epistaxis | - | - |
| Pharyngeal fistula | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; tube thoracostomy or medical intervention indicated; limiting instrumental ADL | Severe symptoms; limiting self care ADL; endoscopic or operative intervention indicated (e.g., stent or primary closure) | Life-threatening consequences; urgent intervention indicated | Death |
| Pharyngeal hemorrhage | Mild symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated | Transfusion, radiologic, endoscopic, or operative intervention indicated (e.g., hemostasis of bleeding site) | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Pharyngeal mucositis | Endoscopic findings only; minimal symptoms with normal oral intake; mild pain but analgesics not indicated | Moderate pain and analgesics indicated; altered oral intake; limiting instrumental ADL | Severe pain; unable to adequately aliment or hydrate orally; limiting self care ADL | Life-threatening consequences; urgent intervention indicated | Death |
| Pharyngeal necrosis | - | - | Inability to aliment adequately by GI tract; tube feeding or TPN indicated; radiologic, endoscopic, or operative intervention indicated | Life-threatening consequences; urgent operative intervention indicated | Death |
| Pharyngeal stenosis | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic (e.g., noisy airway breathing), but causing no respiratory distress; medical management indicated (e.g., steroids); limiting instrumental ADL | Limiting self care ADL; stridor; endoscopic intervention indicated (e.g., stent, laser) | Life-threatening airway compromise; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Pharyngolaryngeal pain | Mild pain | Moderate pain; limiting instrumental ADL | Severe pain; limiting self care ADL | - | - |
| Pleural effusion | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; intervention indicated (e.g., diuretics or limited therapeutic thoracentesis) | Symptomatic with respiratory distress and hypoxia; surgical intervention including chest tube or pleurodesis indicated | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Pleural hemorrhage | Asymptomatic; mild hemorrhage confirmed by thoracentesis | Symptomatic or associated with pneumothorax; chest tube drainage indicated | >1000 ml of blood evacuated; persistent bleeding (150-200 ml/hr for 2 - 4 hr); persistent transfusion indicated; elective operative intervention indicated | Life-threatening respiratory or hemodynamic compromise; intubation or urgent intervention indicated | Death |
| Pleuritic pain | Mild pain | Moderate pain; limiting instrumental ADL | Severe pain; limiting self care ADL | - | - |
| Pneumonitis | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; medical intervention indicated; limiting instrumental ADL | Severe symptoms; limiting self care ADL; oxygen indicated | Life-threatening respiratory compromise; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Pneumothorax | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; intervention indicated (e.g., tube placement without sclerosis) | Sclerosis and/or operative intervention indicated; hospitalization indicated | Life-threatening consequences; urgent intervention indicated | Death |
| Postnasal drip | Mild symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated | - | - | - |
| Productive cough | Occasional/minimal production of sputum with cough | Moderate sputum production; limiting instrumental ADL | Persistent or copious production of sputum; limiting self care ADL | - | - |
| Pulmonary edema | Radiologic findings only; minimal dyspnea on exertion | Moderate dyspnea on exertion; medical intervention indicated; limiting instrumental ADL | Severe dyspnea or dyspnea at rest; oxygen indicated; limiting self care ADL | Life-threatening respiratory compromise; urgent intervention or intubation with ventilatory support indicated | Death |
| Pulmonary fibrosis | Mild hypoxemia; radiologic pulmonary fibrosis < 25% of lung volume | Moderate hypoxemia; evidence of pulmonary hypertension; radiographic pulmonary fibrosis 25-50% | Severe hypoxemia; evidence of right-sided heart failure; radiographic pulmonary fibrosis >50 - 75% | Life-threatening consequences (e.g., hemodynamic/pulmonary complications); intubation with ventilatory support indicated; radiographic pulmonary fibrosis >75% with severe honeycombing | Death |
| Pulmonary fistula | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; tube thoracostomy or medical management indicated; limiting instrumental ADL | Limiting self care ADL; endoscopic stenting or operative intervention indicated | Life-threatening consequences; urgent operative intervention indicated | Death |
| Pulmonary hypertension | Minimal dyspnea; findings on physical exam or other evaluation | Moderate dyspnea, cough; requiring evaluation by cardiac catheterization and medical intervention | Severe symptoms, associated with hypoxemia, right heart failure; oxygen indicated | Life-threatening airway consequences; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Respiratory failure | - | - | - | Life-threatening consequences; urgent intervention, intubation, or ventilatory support indicated | Death |
| Respiratory, thoracic and mediastinal disorders - Other, specify | Asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated | Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental ADL | Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of existing hospitalization indicated; disabling; limiting self care ADL | Life-threatening consequences; urgent intervention indicated | Death |
| Retinoic acid syndrome | Fluid retention; <3 kg of weight gain; intervention with fluid restriction and/or diuretics indicated | Moderate signs or symptoms; steroids indicated | Severe symptoms; hospitalization indicated | Life-threatening consequences; ventilatory support indicated | Death |
| Sinus disorder | Asymptomatic mucosal crusting; blood-tinged secretions | Symptomatic stenosis or edema/narrowing interfering with airflow; limiting instrumental ADL | Stenosis with significant nasal obstruction; limiting self care ADL | Necrosis of soft tissue or bone; urgent operative intervention indicated | Death |
| Sleep apnea | Snoring and nocturnal sleep arousal without apneic periods | Moderate apnea and oxygen desaturation; excessive daytime sleepiness; medical evaluation indicated; limiting instrumental ADL | Oxygen desaturation; associated with hypertension; medical intervention indicated; limiting self care ADL | Cardiovascular or neuropsychiatric symptoms; urgent operative intervention indicated | Death |
| Sneezing | Mild symptoms; intervention not indicated | Moderate symptoms; medical intervention indicated | - | - | - |
| Sore throat | Mild pain | Moderate pain; limiting instrumental ADL | Severe pain; limiting self care ADL; limiting ability to swallow | - | - |
| Stridor | - | - | Respiratory distress limiting self care ADL; medical intervention indicated | Life-threatening airway compromise; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Tracheal fistula | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic; tube thoracostomy or medical intervention indicated; limiting instrumental ADL | Severe symptoms; limiting self care ADL; endoscopic or operative intervention indicated (e.g., stent or primary closure) | Life-threatening consequences; urgent operative intervention indicated (e.g., thoracoplasty, chronic open drainage or multiple thoracotomies) | Death |
| Tracheal mucositis | Endoscopic findings only; minimal hemoptysis, pain, or respiratory symptoms | Moderate symptoms; medical intervention indicated; limiting instrumental ADL | Severe pain; hemorrhage or respiratory symptoms; limiting self care ADL | Life-threatening consequences; urgent intervention indicated | Death |
| Tracheal stenosis | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | Symptomatic (e.g., noisy airway breathing), but causing no respiratory distress; medical management indicated (e.g., steroids) | Stridor or respiratory distress limiting self care ADL; endoscopic intervention indicated (e.g., stent, laser) | Life-threatening airway compromise; urgent intervention indicated (e.g., tracheotomy or intubation) | Death |
| Voice alteration | Mild or intermittent change from normal voice | Moderate or persistent change from normal voice; still understandable | Severe voice changes including predominantly whispered speech; may require frequent repetition or face-to-face contact for understandability; may require assistive technology | - | - |
| Wheezing | Detectable airway noise with minimal symptoms | Moderate symptoms; medical intervention indicated; limiting instrumental ADL | Severe respiratory symptoms limiting self care ADL; oxygen therapy or hospitalization indicated | Life-threatening consequences; urgent intervention indicated | Death |
Articles in category "CTCAE4 Respiratory, thoracic and mediastinal disorders"
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