The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate a man with complications involving the testes following radiation and chemotherapy.
Subjective measures:
(1) libido
Objective measures:
(1) fertility
(2) appearance testes
Management measures:
(1) fertility
(2) libido
Analytic studies:
(1) serum FSH and LH levels
(2) serum testosterone levels
(3) spermatoanalysis: assessment of sperm number, mobility and morphology
(4) flow cytometric analysis: assessment of sperm chromatin integrity
(5) DNA chromatin analysis: assessment of sperm chromatin integrity
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.
|
SOM
|
Grade 1
|
Grade 2
|
Grade 3
|
Grade 4
|
|
libido
|
occasionally suppressed
|
intermittently suppressed
|
persistently suppressed
|
NA
|
|
fertility
|
NA
|
NA
|
oligospermia
|
azoospermia
|
|
appearance testes
|
NA
|
NA
|
NA
|
atrophy
|
|
management of fertility
|
NA
|
NA
|
in vitro fertilization
|
sperm retrieval from banked sperm
|
|
management of libido
|
NA
|
testosterone replacement
|
NA
|
NA
|
total score =
= SUM(points for all 5 items)
LENT score =
= (total score) / 5
|
Analytical
|
Grade 1
|
Grade 2
|
Grade 3
|
Grade 4
|
|
FSH and LH
|
increased FSH; normal LH
|
increased FSH and LH
|
NA
|
NA
|
|
testosterone
|
NA
|
NA
|
NA
|
decreased
|
analytical score =
= (points for FSH and LH) + (points for serum testosterone levels)
Interpretation:
• maximum total score: 17
• minimum LENT score: 0
• maximum LENT score: 3.4
• minimal total analytical score: 0
• maximum total analytical score: 6
