8. NCIC CTCAE Toxicity scoring.

Symptom	Grade I	Grade II	Grade III	Grade IV	Grade V
Gastrointestinal
Anorexia	—	—	—	—	—
Diarrhea	Increase of < 4 stools per day over baseline Increase in ostomy output	Increase of 4–6 stools per day over baseline Moderate increase in ostomy output compared to baseline	Increase of 7 stools per day over baseline Incontinence Hospitalization indicated Severe increase in ostomy output compared to baseline	Life‐threatening consequences Urgent intervention indicated	Death
Gastrointestinal bleeding	Mild symptoms Intervention not indicated	Moderate symptoms Medical intervention or minor cauterization indicated	Transfusion, radiologic, endoscopic or elective operative intervention indicated	Life‐threatening consequences Urgent intervention indicated	Death
Nausea	Loss of appetite without alteration in eating habits	Oral intake decreased without significant weight loss, dehydration or malnutrition	Inadequate oral caloric or fluid intake; tube feeding, TPN, or hospitalization indicated	—	—
Pain/cramping	Mild pain	Moderate pain Limiting instrumental ADL	Severe pain Limiting self‐care ADL	—	—
Vomiting	1–2 episodes (separated by 5 minutes) in 24 hours	3–5 episodes (separated by 5 minutes) in 24 hours	≥ 6 episodes (separated by 5 minutes) in 24 hours Tube feeding, TPN or hospitalization indicated	Life‐threatening consequences Urgent intervention indicated	Death
Bladder changes
Cystitis	Microscopic hematuria Minimal increase in frequency, urgency, dysuria or nocturia New‐onset incontinence	Moderate hematuria Moderate increase in frequency, urgency, dysuria, nocturia or incontinence Urinary catheter placement or bladder irrigation indicated Limiting instrumental ADL	Gross hematuria Transfusion, IV medications or hospitalization indicated Elective endoscopic, radiologic or operative intervention indicated	Life‐threatening consequences Urgent radiologic or operative intervention indicated	Death
Fistula	—	Non‐invasive intervention indicated Urinary or suprapubic catheter placement indicated	Limiting self‐care ADL Elective radiologic, endoscopic or operative intervention indicated Permanent urinary diversion indicated	Life‐threatening consequences Urgent radiologic or operative intervention indicated	Death
Genitourinary pain	Mild pain	Moderate pain Limiting instrumental ADL	Severe pain Limiting self‐care ADL	—	—
Hematuria	Asymptomatic Clinical or diagnostic observations only Intervention not indicated	Symptomatic Urinary catheter or bladder irrigation indicated Limiting instrumental ADL	Gross hematuria Transfusion, IV medications or hospitalization indicated Elective endoscopic, radiologic or operative intervention indicated Limiting self‐care ADL	Life‐threatening consequences Urgent radiologic or operative intervention indicated	—
Ureteric obstruction	Asymptomatic Clinical or diagnostic observations only	Symptomatic but no hydronephrosis, sepsis or renal dysfunction Urethral dilation, urinary or suprapubic catheter indicated	Symptomatic and altered organ function (e.g. hydronephrosis or renal dysfunction) Elective radiologic, endoscopic or operative intervention indicated	Life‐threatening consequences Urgent intervention indicated	—

ADL: activities of daily living; IV: intravenous; NCIC CTCAE: National Cancer Information Center Common Terminology Criteria for Adverse Events; TPN: total parenteral nutrition.