9. Modified LENT‐SOMA radiation therapy late effects.

Toxicity	Grade I	Grade II	Grade III	Grade IV
Genitourinary	Nocturia twice baseline or non‐narcotic medication (e.g. α‐blocker) once per day increase over baseline Microscopic hematuria Light mucosal atrophy and minor telangiectasia Dysuria not requiring medication Incontinence or dribbling not requiring sanitary pad (over baseline)	Frequency ≤ every hour requiring α‐blocker > once per day Nocturia > twice baseline Generalized telangiectasias Macroscopic hematuria requiring ≤ 2 cauterization Dysuria requiring medication (non‐narcotic > once per day or narcotic for pain ≥ 1 per day over baseline) ≤ 2 dilations Foley or self‐catheterization for ≤ 2 weeks' incontinence requiring ≤ 2 pads (over baseline)	Frequency > 1 every hour or dysuria requiring narcotic > once per day Nocturia > 1 per hour Reduction in bladder capacity (150 cm3) ≥ 1 blood transfusions or > 2 cauterizations for bleeding Narcotic use > once per day Hyperbaric oxygen Foley or self‐catheterization > 2 weeks TURP or > 2 dilations Incontinence requiring > 2 pads (over baseline)	Gross hematuria requiring > 1 blooded transfusion Severe hemorrhagic cystitis or ulceration requiring urinary diversion with or without cystectomy

LENT‐SOMA: Late Effects Normal Tissue Task Force‐Subjective, Objective, Management, Analytic; TURP: transurethral resection of the prostate.