TOXICITY GRADING SYSTEMS - A COMPARISON BETWEEN THE WHO SCORING SYSTEM AND THE COMMON TOXICITY CRITERIA WHEN USED FOR NAUSEA AND VOMITING

Background: The Common Toxicity Criteria adopted by the NCI in the USA for grading toxicity in cancer clinical trials have been compared to the WHO scoring system which is still in use in Europe. Patients & met hods: Sixty-six patients undergoing emetic chemotherapy at the Netherl ands Cancer Institute completed questionnaires, 32 according to the WH O criteria and 34 to the Common Toxicity Criteria, on the severity, fr equency and duration of gastro-intestinal toxicity. Their answers were then compared to the scores coded by research nurses and physicians. The nurses coded acute toxicity when the patients were discharged, and the doctors coded overall toxicity when the patients returned for the subsequent course of chemotherapy. To evaluate the coding systems, an estimate was made of the percentage agreement between the patients' a nswers and the nurses' and doctors' ratings. Results: The percentage a greement of the Common Toxicity Criteria with the patients' own experi ences of nausea and vomiting was considerably better than that of the WHO score. The Gamma statistic confirmed this. The Common Toxicity Cri teria have now been adopted for grading toxicity in studies of the Ear ly Clinical Trials Group of the EORTC and are recommended for use in o ther clinical trials