The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate changes to the skin and subcutaneous tissue occurring as a complication following radiation and chemotherapy.
Subjective measures:
(1) scaliness, roughness
(2) sensation
Objective measures:
(1) edema
(2) alopecia (scalp)
(3) pigmentation change
(4) ulcer, necrosis
(5) telangiectasia
(6) fibrosis, scar
(7) atrophy, contraction (depression)
Management measures:
(1) dryness
(2) sensation
(3) ulcer
(4) edema
(5) fibrosis, scar
Analytic studies:
(1) Color photography.
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 |
|
scaliness, roughness |
present, asymptomatic |
symptomatic |
requires constant attention |
NA |
|
sensation |
hypersensitive, pruritis |
intermittent pain |
persistent pain |
debilitating |
|
edema |
present, asymptomatic |
symptomatic |
secondary dysfunction |
total dysfunction |
|
alopecia (scalp) |
thinning |
patchy, permanent |
complete, permanent |
NA |
|
pigmentation change |
transitory, slight |
permanent, marked |
NA |
NA |
|
ulcer, necrosis |
epidermal only |
dermal |
subcutaneous |
bone exposed |
|
telangiectasia |
minor |
moderate, < 50% |
gross, >= 50% |
NA |
|
fibrosis, scar |
present, asymptomatic |
symptomatic |
secondary dysfunction |
total dysfunction |
|
atrophy, contraction (depression) |
present, asymptomatic |
symptomatic, < 10% |
secondary dysfunction, 10-30% |
total dysfunction, > 30% |
|
dryness management |
NA |
NA |
medical intervention |
NA |
|
sensation management |
NA |
intermittent medical intervention |
continuous medical intervention |
NA |
|
ulcer management |
NA |
NA |
medical intervention |
surgical intervention, amputation |
|
edema management |
NA |
NA |
medical intervention |
surgical intervention, amputation |
|
fibrosis, scar management |
NA |
NA |
medical intervention |
surgical intervention, amputation |
total score =
= SUM(points for all 14 items)
LENT score =
= (total score) / 14
Interpretation:
• maximum total score: 49
• minimum LENT score: 0
• maximum LENT score: 3.5
Specialty: Hematology Oncology, Dermatology
