Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
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Volume 15, Number 6, December 2022, pages 285-296

Radiation in Gastroenterology


Table 1. Grading of Radiation Esophagitis (CTCAE Version 5.0)
CTCAE version 5.0
CTCAE: Common Terminology Criteria for Adverse Events.
Grade 1Asymptomatic
Grade 2Symptomatic; altered swallowing/eating; oral supplements indicated
Grade 3Severely altered swallowing/eating; tube feeding, total parenteral nutrition, or hospitalization indicated
Grade 4Life-threatening consequences; urgent operative intervention indicated
Grade 5Death


Table 2. Grading of Radiation Esophagitis (RTOG Scale)
RTOG scale
RTOG: Radiation Therapy Oncology Group.
Grade 1Mild dysphagia or odynophagia, requires soft diet, topical anesthetic or non-narcotic agents
Grade 2Moderate dysphagia or odynophagia, requiring liquid diet or narcotic agents
Grade 3Severe dysphagia or odynophagia with dehydration or weight loss (> 15% or pretreatment baseline), requiring nasogastric feeding
Grade 4Complete stricture, ulceration, perforation or fistula
Grade 5Death


Table 3. Radiation Injuries to Certain Organs
OrganRadiation dose threshold (Gy)Period of time to develop effect
Gastrointestinal mucosal lining loss66 to 9 days
Reduced production of bone marrow hematopoietic cells0.51 to 2 months
Ovaries - permanent sterility2.5 to 6< 1 week
Testes - temporary sterility0.153 to 9 weeks
Permanent sterility3.5 to 63 weeks
Skin - erythema3 to 61 to 4 weeks
Temporary hair loss (depilation)42 to 3 weeks
Death and scarring (necrosis)5 to 101 to 4 weeks