Table 1 Grading system for radiation induced lung toxicity

Grade 0

No changes

No changes

Normal

Grade 1

Asymptomatic or mild symptoms

Asymptomatic, only radiological, or tomographic findings

Radiographic changes, symptoms do not require steroids

Grade 2

Moderate symptoms of pneumonitis (severe cough) and radiographic changes (radiographic patches)

Symptomatic, does not interfere with daily activities

Steroids required or tap of effusion

Grade 3

Severe symptoms of pneumonitis, dense radiographic changes

Symptomatic, interferes with daily activities, requires supplemental O2

Oxygen required

Grade 4

Symptoms of severe respiratory failure requiring assisted ventilation or continuous O2

Threatens life, requires mechanical ventilation support

Requires assisted ventilation

Grade 5

Death-related late effects of radiotherapy

Death related severe pneumonitis

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