Table 5.

Diagnosis and grading for radiation-induced pneumonitis and fibrosis*

Adverse Event	Grade 1	Grade 2	Grade 3	Grade 4	Grade 5
Radiation Pneumonitis (Radiographic evidence of acute radiation pneumonitis required for the diagnosis)	Radiographic evidence only, or minimal or mild symptoms of cough or dyspnea not requiring medication	Cough or dyspnea, requires prescribed medications or increase in steroid use from baseline, but does not interfere with ADL	Severe cough or dyspnea, interferes with ADL, or requiring oxygen (intermittent or continuous), or increase in baseline oxygen use	Respiratory insufficiency requiring assisted ventilation	Respiratory insufficiency directly contributing to death
Radiation pulmonary fibrosis (radiographic evidence of radiation fibrosis needed for the diagnosis)	Radiographic evidence of radiation fibrosis with no or mild dyspnea	Radiation fibrosis causing dyspnea but does not interfere with ADL	Radiation fibrosis causing dyspnea that interferes with ADL, or requiring oxygen or increase in baseline home oxygen use	Radiation fibrosis that causes respiratory insufficiency, requires assisted ventilation	Radiation fibrosis directly contributing to death

• ADL=Activities of Daily Life