The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate a woman for vulvar complications following radiation and chemotherapy.
Subjective measures:
(1) dryness
(2) pruritis
(3) pain
Objective measures:
(1) pigmentation change
(2) alopecia
(3) atrophy
(4) appearance
(5) ulceration or necrosis
(6) fibrosis
(7) edema
(8) introital stenosis
(9) serous transudate
Management measures:
(1) pruritis or atrophy
(2) pain
(3) ulceration
(4) introital stenosis
Analytic studies:
(1) color photograph: Assess changes in skin, mucous and telangiectasia
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 |
|---|---|---|---|---|
|
dryness |
occasional |
intermittent |
persistent |
NA |
|
pruritis |
occasional and minimal |
intermittent and tolerable |
persistent and intense |
refractory and excruciating |
|
pain |
occasional and minimal |
intermittent and tolerable |
persistent and intense |
refractory and excruciating |
|
pigmentation change |
patchy |
confluent |
NA |
NA |
|
alopecia |
partial |
complete |
NA |
NA |
|
atrophy |
patchy |
confluent |
NA |
NA |
|
appearance |
telangiectasia without bleeding |
telangiectasia with gross bleeding |
NA |
NA |
|
ulceration or necrosis |
superficial, <=1 square cm |
superficial, >1 square cm |
deep |
fistula |
|
fibrosis |
NA |
NA |
partial |
complete |
|
edema |
NA |
NA |
partial |
complete |
|
introital stenosis |
NA |
NA |
partial |
complete |
|
serous transudate |
occasional |
intermittent |
persistent |
refractory |
|
management of pruritis or atrophy |
occasional hormone cream |
intermittent hormone cream |
regular hormone cream |
NA |
|
management of pain |
occasional non-narcotic |
regular non-narcotic |
regular narcotic |
surgical intervention |
|
management of ulceration |
conservative |
wound care |
debridement |
graft |
|
management of introital stenosis |
occasional dilation |
intermittent dilation |
persistent dilation |
surgical repair |
total score =
= SUM(points for all 16 items)
LENT score =
= (total score) / 16
Interpretation:
• maximum total score: 54
• minimum LENT score: 0
• maximum LENT score: 3.38
Specialty: Hematology Oncology, Obstetrics & Gynecology
