The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate vascular injury occurring as a complication following radiation and chemotherapy.
Subjective measures:
(1) arterial
(2) venous
Objective measures:
(1) arterial
(2) venous
Management measures:
(1) arterial
(2) venous
Analytic studies:
(1) Doppler ultrasound: assessment of blood flow and detection of abnormalities
(2) angiography: assessment of lumen size and collateralization
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 |
|
arterial symptoms |
no clinical symptoms |
clinical symptoms of ischemia during exercise |
clinical of symptoms of ischemia at rest |
necrosis |
|
venous symptoms |
asymptomatic |
thrombosis not requiring systemic anticoagulant therapy |
thrombosis requiring systemic anticoagulant therapy |
pulmonary embolism and/or thrombosis requiring surgery |
|
arterial findings |
minor ischemia |
intermittent ischemia |
intense ischemia |
necrosis |
|
venous findings |
minor edema |
intermittent edema |
ulcer or active thrombosis |
pulmonary embolism |
|
management of arterial disease |
behavioral change |
permanent medical treatment |
conservative surgery |
amputation |
|
management of venous disease |
elastic bandage |
elastic bandage, regular antibiotic and/or anticoagulant therapy |
regular parenteral anticoagulant therapy |
surgery |
where:
• Some of the entries here seem somewhat redundant.
• Behavioral change includes cessation of smoking, exercise and serum lipid lowering.
total score =
= SUM(points for all 6 items)
LENT score =
= (total score) / 6
Interpretation:
• maximum total score: 20
• minimum LENT score: 0
• maximum LENT score: 4.00
Specialty: Hematology Oncology, Cardiology
