Toxic grading.

Every therapeutic trial ever includes reporting on toxicity. In oncology, we rely heavily on the NCI’s “standardized” Criteria for Adverse Events (CTCAE) metrics. Despite its best efforts, though, it may not be as standardized as we think. In this simple study, two senior rad onc residents retrospectively and independently assigned CTCAE toxicities to 100 patient status check visits based on free text clinical assessments. Disagreements were captured in 93 of 100 encounters. Yowzas. This could be due to, as with all things oncology, increasing complexity. The current version (v5.0) has 837 terms compared to <50 in v1.0. TBL: While clearly important, toxicity data should be interpreted with a grain of salt. | Fairchild, Int J Radiat Oncol Biol Phys 2020

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