Leicestershire, Northamptonshire & Rutland Cancer Network

Common Toxicity Criteria

Toxicity Allergic 0 None 1 Transient rash, drug fever <380C (100.4 0F) 2 Urticaria, drug fever <380C (100.4 0F) and/or asymptomatic bronchospasm 3 Symptomatic bronchospasm requiring parenteral medication(s) with or without urticaria; allergy related oedema / angioedema Requiring IV fluids 4 Anaphylaxis

Alopecia Anorexia

Normal None

Mild hair loss Loss of appetite 1.5 x 109/I normal 10.0g/dl normal 75 x 109/I normal 3.0 x 109/I normal Mild increase in loose, watery colostomy output compared with pretreatment

Pronounced hair loss Oral intake significantly decreased 1.0 1.4 x 109/I 8.0-9.9g/dl 50-74 x 109/I 2.0-2.9 x 109/I

Requiring feeding tube or parenteral nutrition <0.5 x 109/I

Blood counts Neutrophils Blood counts Haemoglobin Blood counts Platelets Blood counts White blood count Diarrhoea (patients with colostomy)

Within normal limits Within normal limits Within normal limits Within normal limits None

0.5 0.9 x 109/I 6.5-7.9g/dl 10-49 x 109/I 1.0-1.9 x 109/I

<6.5g/dl <10 x 109/I <1.0 x 109/I

Diarrhoea (patients without colostomy)

None

Moderate increase in loose, watery colostomy output compared with pre-treatment, but not interfering with normal activity Increase of Increase of 4-6 <4 stools/day stools/day, or over prenocturnal treatment stools

Severe increase in loose, watery colostomy output compared with pre-treatment, interfering with normal activity Increase of >7 stools/day, or incontinence, or need for parenteral support for dehydration Skin changes with pain,

Physiologic consequences requiring intensive care, or haemodynamic collapse

Physiological consequences requiring intensive care, or haemodynamic collapse

Hand-foot skin reaction

None

Skin changes or

Skin changes with pain, not

Document Code: LNRCN/DC/0003/07 Written By: C Clarke Issue Number: 1

LNRCN/DC/0003/07 Common Toxicity Criteria

Date of Issue: Sept 07 Review Date: Sept 09 Authorised By: MMG 3 Aug 07 Page Number: 1/3 Website: Check www.eastmidlandscancernetwork.nhs.uk for latest version

Leicestershire, Northamptonshire & Rutland Cancer Network

Toxicity 0 1 dermatitis without pain >ULN 2.5 x ULN >ULN 1.5 x ULN Increased fatigue over baseline, but not altering normal activities 2 interfering with function >2.5 5.0 x ULN >1.5 3.0 x ULN Moderate (decrease in performance status by level 1) or causing difficulty performing some activities Oral intake significantly decreased Mild objective weakness interfering with function, but not interfering with activities of daily living Objective sensory loss or paresthesia (including tingling), interfering with function, but not interfering with activities of daily living Moderate pain: pain or analgesics interfering with function but not interfering with activities of daily living Painful erythema, oedema or ulcers but can eat or swallow 3 interfering with function 5.5 20.0 x ULN 3.0 10.0 x ULN Severe (decrease in performance status by >2 levels), or loss of ability to perform some activities No significant intake, requiring IV fluids Objective weakness interfering with activities of daily living 4

Hepatic alk phos Hepatic bilirubin Lethargy

UNL UNL None

>20.0 x ULN >10.0 x ULN Bedridden or disabling

Nausea

None

Able to eat

Neuropathy motor

Normal

Subjective weakness but no objective findings

Paralysis

Neuropathy sensory

Normal

Loss of deep tendon reflexes or paresthesia (including tingling) but not interfering with function Mild pain not interfering with function

Sensory loss of paresthesia interfering with activities of daily living

Permanent sensory loss that interferes with function

Pain

None

Severe pain: pain or analgesics severely interfering with activities of daily living Painful erythema oedema, or ulcers requiring IV hydration

Disabling

Stomatitis

None

Painless ulcers, erythema or mild soreness

Severe ulceration or requires parenteral or enteral nutritional

Document Code: LNRCN/DC/0003/07 Written By: C Clarke Issue Number: 1

LNRCN/DC/0003/07 Common Toxicity Criteria

Date of Issue: Sept 07 Review Date: Sept 09 Authorised By: MMG 3 Aug 07 Page Number: 2/3 Website: Check www.eastmidlandscancernetwork.nhs.uk for latest version

Leicestershire, Northamptonshire & Rutland Cancer Network

Toxicity 0 1 2 3 4 support or prophylactic intubation Requiring parenteral nutrition, or physiological consequences requiring intensive care; haemodynamic collapse

Vomiting

None

1 episode in 24 hours

2-5 episodes in 24 hours

>6 episodes in 24 hours, or need for IV fluids

Document Code: LNRCN/DC/0003/07 Written By: C Clarke Issue Number: 1

LNRCN/DC/0003/07 Common Toxicity Criteria

Date of Issue: Sept 07 Review Date: Sept 09 Authorised By: MMG 3 Aug 07 Page Number: 3/3 Website: Check www.eastmidlandscancernetwork.nhs.uk for latest version