Radiation Oncology/Performance scales


Karnofsky Performance Scale

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  • 100 - Normal; no complaints; no evidence of disease
  • 90 - Able to carry on normal activity; minor signs or symptoms of disease
  • 80 - Able to carry on normal activity with effort; some signs or symptoms of disease
  • 70 - Cares for self; unable to carry on normal activity or do active work
  • 60 - Requires occasional assistance but is able to care for most personal needs
  • 50 - Requires considerable assistance and frequent medical care
  • 40 - Disable; requires special care and assistance
  • 30 - Severely disabled; hospitalization is indicated although death not imminent
  • 20 - Very sick; hospitalization necessary; active support treatment is necessary
  • 10 - Moribund; fatal processes progressing rapidly
  • 0 - Dead


  • 1948: No PMID Full text — "The use of the nitrogen mustards in the palliative treatment of carcinoma." (Karnofsky DA, Cancer 1948;1(4):634-656)
    • An early publication of the Karnofksy scale. Used to assess improvement in performance status following treatment.

ECOG (Zubrod) Performance Scale

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  • 0 (Karnofsky 90-100) - Fully active; able to carry on all predisease activities without restriction
  • 1 (Karnofsky 70-80) - Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. For example, light housework, office work.
  • 2 (Karnofsky 50-60) - Ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours.
  • 3 (Karnofsky 30-40) - Capable of only limited self-care; confined to bed or chair 50% or more of waking hours.
  • 4 (Karnofsky 10-20) - Completely disabled. Cannot carry on self-care. Totally confined to bed.
  • 5 - Dead

Lansky (Pediatric) Performance Scale

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  • 100 - Fully active, normal
  • 90 - Minor restrictions in physically strenuous activity
  • 80 - Active, but tires more quickly
  • 70 - Both greater restriction of and less time spent in play activity
  • 60 - Up and around, but minimal active play; keeps busy with quieter activities
  • 50 - Gets dressed, but lies around much of the day; no active play, able to participate in all quiet play and activities.
  • 40 - Mostly in bed; participates in quiet activities
  • 30 - In bed; needs assistance even for quiet play
  • 20 - Often sleeping; play entirely limited to very passive activities
  • 10 - No play; does not get out of bed