The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate a patient with muscle or soft tissue complications following radiation and chemotherapy.
Subjective measures:
(1) pain
(2) function
Objective measures:
(1) edema
(2) mobility and extremity function
(3) fibrosis
(4) atrophy
(5) contraction
Management measures:
(1) pain
(2) edema
(3) mobility and extremity function
(4) fibrosis
(5) atrophy
Analytic studies:
(1) MRI
If no toxicity is present, then the 0 points are assigned.
If a toxicity is present, then the grade indicates the number of points to assign.
|
|
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
pain |
occasional and minimal |
intermittent and tolerable |
persistent and intense |
refractory and excruciating |
|
function |
interferes with athletic recreation |
interferes with work |
interferes with daily activity |
complete lack |
|
edema |
present and asymptomatic |
symptomatic |
secondary dysfunction |
total dysfunction |
|
mobility and extremity function |
present and asymptomatic |
symptomatic |
secondary dysfunction |
no mobility, frozen |
|
fibrosis |
detectable |
<= 20% of muscle |
20.1 – 50% of muscle |
> 50% of muscle |
|
atrophy |
<= 10% |
10.1 – 20% |
20.1 – 50% |
> 50% |
|
contraction |
NA |
<= 10% linear field |
10.1 – 30% linear field |
> 30% linear field |
|
management of pain |
occasional non-narcotic |
regular non-narcotic |
regular narcotic |
surgical intervention |
|
management of edema |
NA |
compression |
medical interventions |
surgical intervention |
|
management of mobility and extremity function |
occasional physiotherapy |
intermittent physiotherapy |
persistent physiotherapy or medical interventions |
surgical intervention |
|
management of fibrosis |
occasional physiotherapy |
intermittent physiotherapy |
NA |
surgical intervention |
|
management of atrophy |
NA |
intermittent physiotherapy |
NA |
surgical intervention |
total score =
= SUM(points for all 12 items)
LENT score =
= (total score) / 12
Interpretation:
• maximum total score: 48
• minimum LENT score: 0
• maximum LENT score: 4.0
Specialty: Hematology Oncology, Surgery, orthopedic
