NCI CTCAE Mucositis Grading
NCI Common Terminology Criteria for Adverse Events (CTCAE v5.0) grading for oral mucositis. Used to standardise reporting and guide management decisions in oncology patients.
Score interpretation
Asymptomatic or mild symptoms. Erythema or ulceration < 1cm.
→ Oral hygiene protocol. Saline/sodium bicarbonate rinses. Monitor. No treatment break required.
Moderate pain. Not interfering with oral intake. Modified diet indicated.
→ Analgesic mouthwash (lidocaine). Soft/liquid diet. Consider treatment delay if unable to maintain nutrition. Nutritional support assessment.
Severe pain. Significantly interfering with oral intake.
→ IV/NG nutritional support. Systemic analgesia. Treatment break. Consider IV fluids. Culture for superinfection (HSV, Candida). Oncology/haematology review.
Life-threatening consequences. Urgent intervention required.
→ Hospitalise. IV analgesia (PCA/opioids). IV fluids and nutrition. G-CSF if neutropenic. Empirical antifungal/antiviral. Consider chemotherapy dose reduction or cessation. Palliative team involvement.
Interpretation bands for the Mucositis Grade. Apply clinical judgement and local guidance.
References
- National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. 2017.
- Elad S, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2020;126(19):4423-4431.
Related
Curated clinical cross-links plus same-class fallbacks.
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Zoledronic Acid · Bisphosphonate (IV)
- Denosumab · RANK Ligand Inhibitor (Anti-resorptive)
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Zoledronic Acid · IV Bisphosphonate
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.